How will health practitioners reopening affect benefits plans?

The Ontario government is giving health-care providers, including dentists, massage therapists, optometrists and psychologists, the green light to gradually reopen their practices.

The order from the province’s chief medical officer of health also included chiropractors, physiotherapists, dieticians, naturopaths and acupuncturists. However, it stipulated that the approved health-care providers can only reopen if their regulatory colleges allow them to do so and if they follow Ministry of Health requirements for physical distancing and sanitization. The order also encouraged providers to limit in-person visits for the time being.

Health-care providers started reopening their practices in British Columbia, Alberta, Saskatchewan, Manitoba, New Brunswick and Prince Edward Island in May. Quebec is allowing providers to do so as of today and Nova Scotia as of June 5.

Read: Canadian plan sponsors seeing sharp declines in health, dental claims

Chris Pryce, founder and president of Human Capital Benefits, says the order could mean that plan sponsors with employees in Ontario will start to see an increase in paramedical claims over the coming months, though he doesn’t expect them to hit their pre-pandemic levels in the short term.

“I do not [expect] we’re going to see 130 per cent of what we had before, but certainly we will see a dramatic ramp-up in terms of patients being called, patients being encouraged to come in, ‘Just put a mask on and it’s OK’ and that’ll be it,” he says. “Plan sponsors who were counting on a bit of a reprieve for the remainder of the year . . . I think that reprieve is going to be short-lived.”

However, Pryce doesn’t expect dental claims to rebound the same way, given the Royal College of Dental Surgeons of Ontario’s particularly stringent reopening requirements. The college said dentists must have an inventory of appropriate personal protective equipment — including N95 masks for aerosol-generating procedures — stagger appointment times, take patients’ temperatures upon arrival, maintain physical distancing except for required patient care and leave their operating rooms clear for up to three hours and 45 minutes after a procedure to remove any airborne contaminants.

Read: What dental benefits topics should plan sponsors be considering?

“Does that sound inviting to you? I don’t see dentistry coming back any time soon,” says Pryce. He estimates that dental claims could return in the summer months at no more than 30 per cent of their pre-pandemic levels.

“Even if we start off at 40 per cent of pre-COVID [levels] until the fall, maybe that goes up to 70 per cent and we see a little bit of a push by dentists at the end of the year . . . to put through some extra work, but I still think we’re going to be down in terms of dental for the remainder of the year. It’s going to take time for people to feel comfortable going back.”

Canadian plan sponsors saw significant decreases in their extended health and dental claims over the past three months due to the forced closure of many health-care practitioners. Eckler Ltd. found its large self-insured clients had seen extended health claims drop by 40 per cent between March and April and dental claims drop by between 80 and 90 per cent in the same time period.

“Based on what we saw in April, clients were seeing a pretty significant reduction in terms of their health expenses, because people weren’t able to access the services,” says Pryce, speaking about his own plan sponsor clients. He notes one large employer that normally sees monthly health claims of around $7,000, excluding prescription drugs, only had around $1,500 of those claims in April.

Read: More Canadian insurers reducing benefits plan premiums

The big question for plan sponsors is how long insurers will keep their extended health and dental premium reductions in place as health-care providers across the country begin to reopen, notes Pryce. “I think [insurers] are going to pull those premium credits pretty quick, because employees can go out and use those [services] now.”