Standard for Mental Health in the Workplace

Is your workplace safe?  Does your Health and Safety Committee do everything they can to help to mitigate risks of occupational injury and minimize employee injury and absenteeism?  Are they considering the Mental Health of your employees in addition to Physical Hazards?  If not, then they aren’t minimizing injury and absenteeism.  Mental Health issues are now the leading cause of disability in Canada.  The Standard for Psychological Health & Safety in the Workplace provides a framework for preventing Mental Health injury at work.  Adherence to these standards will help to protect your employee from all workplace hazards.

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Mental Health First Aid

It’s the law.  Every employer should have staff that are trained to know what to do when someone has an accident or serious acute medical condition on the job.  Companies fund employees to take CPR and First aid to help their coworkers and save lives.  But what about those whose injuries aren’t as visible, but are just as perilous?  Just like CPR and First Aid, Mental Health First Aid can save lives.  Employees can be trained to identify signs of distress and respond appropriately with empathy and resources to help avert crisis. 

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Mindfulness & Your Mental State

I always find it amazing how the simplest things have become complicated in modern society.  Ever present demands from work, home life and notifications from social media and news connect and distract us like never before.  Some days, even the best of us struggle to be present and involved in what is going on around us.  It is these days where mindfulness training can help us focus, perform and excel.  Something as simple as consciously controlling breathing can make a world of difference to someone’s mental state.

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Biometric Screening Saves Lives

Most people judge their health by how they feel.  Even those that are clearly unhealthy will often say they feel fine or have a “It Can’t Happen To Me” attitude.  Biometric Screenings can help to provide that wake up call that some people need.  These screenings provide quantifiable results and interpretation from a health professional.  For some, the results are not a surprise to the employee but for others who feel they are in good health, these screenings can literally be a life saver.

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Wellness Challenges Work!

Goal setting is a great skill for someone who is looking to improve their health.  Workplace Wellness Challenges can help employees establish, and stick to their Well-Being goals.  By encouraging small groups of employees to participate in healthy activities, employers are able to organically create groups that support each-other and help build a positive company culture of compassion and health.

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The Importance of Employee Communications

Would your company be in business if your clients didn’t know it existed?  Of course not.  Marketing and Communication are key to the success of a business and a Wellness Program.  As consultants, we have come across many organizations that are doing great things for their employee’s well-being, but have neglected to properly communicate the program’s features, or even existence!  Develop your communication strategy before implementing solutions.

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What the New Changes to OHIP+ Mean to Employees

The new Conservative government in Ontario hasn’t wasted any time announcing changes to the previous government’s OHIP+ drug program for children.  Even though this means slightly higher costs for companies, I think that this change is better for employees.

Firstly, due to rushed implementation, coordination was an issue for many employees, especially when it came to drugs that fell under the OHIP+ Exceptional Access Program (EAP).  For these claims, employees were often left paying the full amount out of pocket until their EAP paperwork, which included physician recommendations, was completed, reviewed, and approved.

Secondly, the number of drugs that require EAP approval is relatively small, but it does include several alternative forms of medications that are prescribed to children.  This caused confusion for employees, many of whom became upset with their employers and insurers as a result.  The new program eliminates this issue.

The OHIP+ program sounded great for employers, but when you look at the low volume and cost associated with claims for the covered medications, the savings are not significant, and the issues related to the EAP caused more issues for employers than the savings were worth. 

While the implementation date is not yet known, the change that will impact members and sponsors of private plans most is that OHIP+ will now only provide payment if a private plan doesn’t. This means that the small savings that employers were hoping to get from this program won’t have time to materialize.

Large Amount Pooling

It has been hard to avoid the news stories in the last couple of years about rising drug prices and new drugs with very expensive price tags.  This is both great leap forward for those in need of treatment, and a cause for anxiety for sponsors of private drug programs.  One thing that it shouldn’t be is an opportunity for insurance companies to line their pockets.

Some of the insurers in Canada have taken advantage of the uncertainty around these drug claims to increase their rates by up to 20% beyond a reasonable level, and create disparity in premiums from one client to another.  While other advisors accept this as a reality of the market, HCG has taken action.

For clients who meet certain criteria and whose insurer is over-charging for Large Claim Pooling protection, HCG offers appropriately priced coverage without changing your insurer.  Our proprietary product allows us to place the Stop Loss risk with a separate insurer while having your claims paid by your current provider.

The result is lower costs for the benefits plan with no changes in your coverage or liability and with absolutely no change to the claiming process for employees.  The savings are permanent as there is no marketing investment by the insurer in our proprietary rates.  This means that the savings are sustainable from year to year, unlike those that are often received when marketing the entire benefits plan.

Some clients choose to re-invest these savings in expanding wellness programming or other benefits coverage, while others see it as an opportunity to offset rising costs in other areas of their benefits plans.

To see if your organization is eligible and would benefit from our Stop Loss Pooling product, contact HCG today.

OHIP+ - The Ontario Youth Drug Plan

Effective January 1, 2018, the Ontario government will provide “free” drug coverage for everyone under the age of 24.  The plan is similar to the Ontario Drug Benefit (OBD) which is available for seniors.

What does this really mean:

For Families:

·         Children under 24 will now have coverage through the OHIP+ program for most prescribed drugs

·         No application is required, just give the child’s health card to the pharmacist along with the prescription

·         If your employer’s benefits only covered a portion of the drug or dispensing fee cost, you may receive more coverage under this program

·         You will still need to keep insurance information up to date with your pharmacist

For Employers:

·         OHIP+ is the first payor for these drugs

o   Drug claims should decrease slightly

o   Most of the drugs that would be prescribed to this group are covered by the province

o   Drugs not covered by the ODB (which include most high cost drugs currently being claimed on employer plans) will continue to be claimed under the company plan

·         Employees may have questions

o   If employees do not provide the child’s health card, your insurance carrier’s systems should reject the claim.  Employees may interpret this as an issue with their coverage.

o   The ODB list covers many, but not all drugs.  You may get questions about why some are covered and others aren’t, especially if your plan has a deductible or co-pay

·         Should you ask your insurance company for a rate adjustment?

o   Especially for groups with lower than average drug claims and higher than average family sizes, claims that will now be shifted to the ODB could make up a significant percentage of overall drug claims

o   The impact to the average group will be minimal as many of these drugs are inexpensive and are claimed with a low frequency

o   Since most high cost drugs are not included, this change will have no impact on your Large Claim Pooling rates.  If these are a concern for you, ask how HCG can help.

Overall, the financial impact of this change to employers is minimal, but could be significant under certain circumstances.  Communicating this change to your employees will help them understand and navigate the new system and ensure that they continue to see the company’s Drug plan as a value added benefit.

Brian Reynolds

Principal - HCG