Medicinal Marijuana in 2019

Medical cannabis is a chosen avenue for medical treatment by over 300,000 Canadians. In January 2019, medical cannabis will become an optional benefit offered by many insurers.

As it is with many treatments, the costs of medical cannabis can vary quite a bit.  To keep plans sustainable, we recommend implementing a maximum benefit amount if you choose to add this coverage.  Amounts could include:

  • $1000

  • $2500

  • $5000

Comprehensive access controls such as pre-determined medical conditions, annual maximums, coverage criteria and eligibility guidelines will ensure appropriate use.  These controls help to support members who need medical cannabis, while also acting responsibly.

Medical cannabis can be helpful for some serious medical conditions, and coverage will only apply to certain conditions and symptoms met by specific criteria:

  • Spasticity or neuropathic pain associated with multiple sclerosis

  • Chemotherapy-induced nausea and vomiting or neuropathic pain associated with cancer

  • Anorexia or neuropathic pain associated with HIV/AIDS

  • Symptoms associated with palliative care




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.