ON Chiropractic Spring 2015 | Page 24

FEATURE STORY / TRENDS IN EXTENDED HEALTH INSURANCE of EHB plans. Often times these individuals can be found in a company’s human resources department. They are where the rubber meets the road. They are the ones who hear feedback from plan members, combine those insights with business realities and objectives from their companies and then look for a plan that meets as many of their requirements as possible — no easy feat. From this tension, however, innovative ideas are often born. Accordingly their perspectives and requirements are a very significant economic driver for the extended health insurance industry. Plan Member Requirements & Satisfaction: The views of individual plan members are often thought to be secondary to economic considerations. That is likely an overstatement. EHB plans are an enormously important tool for companies in the management of employee recruitment, retention and productivity. What’s more, employees increasingly see EHB plans as a right. The 2014 Sanofi Canada Health Care Survey, a benchmarking report in the insurance world, points out that the newest crop of professionals — millennials — are the most likely to see EHB plans as a right of employees. 50% of millennials surveyed saw it that way, the most of any other generation. As a comparison, 76% of plan sponsors see health benefits as a privilege, not a right. Put another way, EHB plans are a major asset when it comes to recruiting and retaining great people. They also come in handy when an employee is being recruited, as they navigate through a challenging time and considering a change in their career. Market Trends: Market trends are linked in some ways to plan member requirements and satisfaction. How a specific plan stacks up against the prevailing view of a standard (or even a premium) plan is relevant data to plan members and sponsors. Does the plan have vision coverage? What hoops do plan members have to jump through to see a chiropractor or psychologist? How big is the major dental coverage? These questions and many more like them represent the way individual plan members and sponsors evaluate the quality of their plan against what other people get. The more often the plan stacks up well against plan members’ expectations the better. One specific example is a trend towards making paramedical coverage available for WHAT'S DRIVING EHB ECONOMICS? 01 Plan Utilization Trends $77 Billion 03 Plan Member Satisfaction 04 Market Trends 67% paid to Canadians in EHB benefits annually of Canadians have Extended Health Benefits Rx Costs vs. Biologics Plan Quality Major Dental MSK Expectations MSK Mental Health Competition Mental Health 02 Employer Requirements 57% $1.6 of Employers called improving health & well-being a priority Employee Satisfaction Team Productivity Financial Pressures 24 05 Fraud & Abuse SPRING 2015 Billion Plan Managers reconcile competing priorities then establish and maintain the plan. Referral Payments Kickbacks Unlicensed Practice