HomebusinesshealthAwards and RecognitionbusinesshealthResourcesBlog
The Callery Group
About UsOur ServicesContact Us

Plan & Predict
How rising paramedical claims, drug reforms, and other trends will affect your workplace benefits

Predicting the future can sometimes be an inexact exercise. (I know I'm still waiting for my personal transporter.) But there is no question that several emerging trends will affect workplace benefits in 2015.

Consider the following examples:

1. Rising paramedical claims

Chiropractors, massage therapists and other paramedical service providers continue to account for some of the fastest-growing benefit costs in the workplace. They represented 19.3% of healthcare claims in 2013, up from 15.5% in 2009, according to Great-West Life.

Some of the increases are caused by inflationary pressures alone, but others can be traced to a rising interest in this category of care. Dig a little deeper into Great-West Life's statistics and you will see that the number of people submitting paramedical claims is up 5-25%, depending on factors such as age. The number of utilized services is increasing by 5-10% a year. Some of the largest increases of all are falling into the "other" category of care including acupuncture and naturopathic treatments.

There is no need to panic. This care is often preventive in nature, can help to reduce absenteeism, and will improve an employee's focus on the job. Rising awareness also enhances the role of related benefits in recruitment and retention efforts.

But the costs still need to be managed. Entrepreneurial paramedical providers sometimes promote the idea of using every available dollar rather than simply scheduling appointments based on need alone. Employers can help protect their plans against this threat by establishing maximum payments per visit or practitioner.

2. Prescription pricing reforms

Prescriptions account for some of the biggest healthcare costs. The good news is that pricing reforms are helping to control the related increases.

The Canadian Generic Pharmaceutical Association recently announced that Canadians will save about $3.8 billion through a three-year agreement with the generic pharmaceutical industry. Under that deal, 18 top-selling generic medications will have prices slashed to 18% of the cost of equivalent brand name drugs.

As of January 2014, the average price of a generic medication was $20. The average brand name medication cost $76.

Still, employees must be encouraged to request these medications. Generic drugs are used to fill 86% of U.S. prescriptions, but fill a mere 67% of prescriptions on this side of the border.

Keep in mind that these reforms – and the wider use of generic drugs -- will become even more important as we look to offset the rising costs of new therapies such as emerging biologic drugs, which on their own account for 15% of drug claims.

3. An increasing focus on mental health

Mental health disorders are playing an increasing role in Long Term Disability (LTD) costs – particularly among white collar and management workers.

Several factors play a role here. Stress and work volumes are on the rise. The LTD claims also increase when the economy recovers and employees are less likely to worry about losing their jobs. On top of this, the white collar and management workers tend to have higher salaries, leading to higher claims.

Luckily, the general awareness around good mental health is growing, thanks to programs like Bell's Let's Talk initiative.

Every step toward earlier treatment will help to keep employees at work.

4. The rising costs of a healthy smile

Dentists play a larger role in overall health than many people think. While many patients focus on a healthy smile, there are broader implications. Gum disease can lead to respiratory problems or diabetes, among other challenges.

Routine cleaning, polishing and scaling makes a difference – and was the top dental procedure of 2013.

Still, there needs to be limits. This time of year, many entrepreneurial-focused dentists take the time to ask patients about the available space in benefits plans rather than focusing on needs alone.

It's why employees need to ask dentists about required care, rather than basing choices on the space in an account.

5. Tighter restrictions on orthotics

Plan providers have introduced tighter controls on orthotics for a good reason. These services have been prone to widespread fraud, leaving some people to file a claim whenever they wanted a new pair of shoes.

The threats have been largely offset by introducing requirements for gait tests, recommendations from medical doctors, and custom-made shoes.

The extra steps take time, but will ensure that plan holders who truly need help will receive the required support.

Top Tips:

  • Monitor fixed deductibles. Increasing prices can leave employees to pay a larger share of fees.
  • Ask paramedical service providers and dentists to recommend treatments based on need rather than the annual caps in a plan.
  • Help sustain drug plans by requesting generic forms of prescription medications.
  • Control the costs of paramedical services by establishing maximum payments per visit or practitioner.

Copyright Notice

All rights reserved. All of the content herein is the sole property of the Callery Group, and may not be reproduced, transmitted, or stored in a retrieval system - in whole or in part - without the written permission of the Callery Group. Links to the originating article at www.callerygroup.com are permitted.

The Buzz Bits
Miscellaneous links to interesting benefits information

Top 3 issues facing group life and health clients today: Insights

How to adapt in a lagging market: smallbizadvisor

Temporary work and no benefits – The growing workplace chasm: Globe and Mail

Employees value their benefits: Benefits Canada

Community Ethics, Big City Expertise

Subscribe to the Buzz Blog

Blog archive

Time To Get Ahead Of The Curve

"We've all been working from home for the last four months and now it looks like we're probably never going to go back to working in the office." It’s a statement I'm hearing every day, as more and more workplaces are discovering that working from home is working out better than anyone ever imagined. [more]

Hitting Reset On The Mindset

We can't afford to think "when this is over." We have a job to do and a chance to step up and really shine [more]

Working From Home

10 ways to communicate effectively in a working-from-home environment  [more]

Managing Paramedical Benefits

Think aboutwhy you offer paramedical benefits in order to manage them effectively  [more]

It's All About The Experience

I thought cell phone dependency was a cliche - until I lost mine far from home  [more]

What Happened When I Lost My Phone

I thought cell phone dependency was a cliche - until I lost mine far from home  [more]

"Mental Health" Doesn't Mean What it Used to Mean

We’re done admiring the problem, and it’s time to take some action  [more]

When There is No Return to Work

An Ontario court has set a limit on employers' return-to-work obligations  [more]

Rooting Out the Root Causes

When benefits fraud gets out of hand, it's a sign of big problems higher up  [more]

Four Key Gaps in Benefits Plans

Annual Sanofi survey zeros in on knowledge gaps in plan management [more]

How to Avoid Falling Through the Generation Gaps

Never mind "the older" and "the younger" generation – there are now five of them [more]

Predictive Analysis and Three Other Trends to Watch

Benefits and wellness programs are never going to be the same again [more]

Pharmacare: A Solution Looking for a Problem

Pharmacare would be such a good idea - if everybody wasn't already covered [more]

When the "Human Side" Gets Right in Your Face

A seriously injured client gives us a whole new perspective on resilience [more]

Is Virtual Health Care the New Must-Have Benefit?

In the age of the smart phone, do we really still need to line up and wait to talk to a doctor? [more]

Three Things I Learned from Doc Martin

When it comes to losing weight, there are a few basics you just can't get around [more]

Top 10 Take-Aways from a Crazy Busy Year

What we can learn from the biggest and most controversial issues we've looked at this year [more]

Engagement is the New Normal

What do employees really want from their jobs? [more]

10 Things You Need to Know about Travel Insurance

How to avoid making the mistakes that could cost you your insurance coverage [more]

How to Give First Aid for Mental Health

There's a new perspective on mental health at work, and it's a real eye-opener [more]

What Else Is In Bill 148 - And Why You Need to Know

There's a lot more to Bill 148 than minimum wage hikes and personal emergency leave [more]

The Next Big Thing in Benefits?

Major insurance providers are looking seriously at covering pharmacogenetic testing [more]

Will Cannabis Legalization Change Attitudes about Testing?

New legal limits for impairment may have a bigger impact than legalization [more]

Avoiding The Dreaded "Claim Rejected"

Benefits administrators are always caught in the middle when claims are rejected [more]

Big Data Takes On Benefits Fraud

Data analysis is starting to make a dent in many benefits fraud schemes [more]

The Chronic Pain Puzzle

Financial costs alone are higher than cancer, heart disease and HIV combined [more]

Financial Wellness: Why Money Management Counseling is Such a Good Idea

Debt counseling and money management education can make a big difference for employees [more]

The Next Big Thing: Mental Health Policy

It's time to get ahead of the curve on this one [more]

Unintended Lessons I've learned about Blogging so far

You never know what's going to happen when you click on a link [more]

Drugs, Alcohol and, Oh Yes, Marijuana

Changing times may require all of us to take a long hard look at our drug-and-alcohol policies [more]

Best Tips For Sleeping Well

If you're just not sleeping well, there are some pretty effective things you can do to make it better [more]

Survey Says: Wellness Programs Improve Overall Satisfaction

It seems that employees' satisfaction with wellness programs spills over into satisfaction with their benefits programs and their jobs in general [more]

Changes Coming to Personal Emergency Leave Laws

Amendments to the Employment Standards Act will significantly increase legally mandated employee leaves [more]

The Good News and the Bad News on Diabetes

We keep hearing about a "diabetes epidemic," but there are things we can do now to improve our odds of beating the statistics [more]

Who's Your "Broker" Working For?

In a world of brokers, agents, advisors and consultants, it's important to stay focused on who's really working for you [more]

The Secret to Really Good Workplace Wellness

Workplace wellness is a way to solve a lot of problems before they even come up [more]

Medical Marijuana - More Questions than Answers

A lack of medical consensus makes drug plan coverage of medical marijuana very difficult [more]

Pharmacogenomics Means Better Prescriptions

A simple DNA test can now help pinpoint which drugs are going to work best for you [more]

Why Airplanes Crash

What one successful CEO learned from air crash investigations – and how it all applies to managing any organization [more]

Not A Delicate Subject Anymore...

How to start the conversation about mental health in the workplace [more]

A Look Inside

There's more to this business that we usually talk about... [more]

Bio What-Now?

Get ready for "generic" biologics. [more]

What You Don't Want to Say to Your Doctor

There are some things that you want to explain to your doctor, and some things you really should stay away from. [more]

Your Dentist's Pet Peeve

Why you should know all the ins and outs of your dental insurance plan before you ever lean back in the chair and open wide [more]

About that Credit Card Travel Insurance

It may be of some value, especially if you have no pre-existing conditions, but you really need to read that fine print [more]

Right Drug, Right Time, Right Cost

Why you should work with your doctor, your pharmacist, and your drug plan to make sure you get optimal treatmenty [more]

Big Smiles

A focus on dental plans will ensure that everyone remains happy [more]

Your Doctor Doesn't Know Everything

When it comes to prescriptions, patients need to be part of the conversation [more]

Prescription for Disaster

Advances in pharmaceuticals are threatening your drug plan [more]

Sleep Easy

Conditions like sleep apnea can be treated, ensuring proper rest and productive days [more]

Easy as EAP

Formal support makes a big difference when employees face personal challenges [more]

Well Done

10 ways to develop an effective workplace wellness program [more]

Mind Matters

Businesses can't afford to ignore the mental health of their employees [more]

Brian's Story

Brian Callery is celebrating 40 years in our business. It's a commitment that makes a difference in his clients' businesses [more]

The Benefits to You

The same plans designed to protect employees will also offer advantages to employers [more]

Lawyer Up

There are legal ramifications around changing benefit plans - especially if an employee is being terminated [more]

Travel Trauma

Dream vacations can turn into nightmares when travel insurance claims are denied [more]

Evolution Solution

Evolving benefit plans will meet employee needs and support recruiting and retention efforts [more]

Plan & Predict

How rising paramedical claims, drug reforms, and other trends will affect your workplace benefits [more]

Who Benefits

Education makes the case for workplace benefit plans [more]

Season of Renewal

Important questions to ask your benefits advisor before inking a deal [more]

Preventive Measures

Paramedical services help keep employees healthy, on the job, and productive [more]

A Bounce in Their Step

Canada Rubber Group employees are embracing their new wellness program [more]

Business Benefits

Shandex Group and Indaco Manufacturing discuss the value of evolving employee benefits plans [more]

A New Mindset

Workplaces can't afford to ignore the mental health of employees [more]

Cost Cutters

10 cost-cutting strategies to protect your benefits plan [more]

Safe Travels

12 ways to protect yourself on your next vacation [more]

Breaking News

Learn from the mistakes of an AOL executive when discussing any changes to your benefits plans [more]

Watch the Gaps

Protect against turnover and lost opportunities by recognizing the generation gaps [more]

Generation Next

Generation Y represents the future of your business - and will see workplace benefits plans in a different way [more]

Absent Minded

Employers are paying the price for absenteeism, but it can be controlled [more]

Think Positive

Programs that build positive workplaces make business sense [more]

Back to School

8 important lessons your employees need to learn about benefits plans [more]

Find a Better Broker

6 questions you should ask anyone who wants to sell you a benefits plan [more]

Plan Your ROI

5 ways employee benefits plans can deliver a real Return on Investment [more]

The Benefit of Benefits

3 ways a benefits plan can improve your company's bottom line. [more]

A Healthy Dose of Information

5 questions for your pharmacist that might save your drug plan and your wallet. [more]

Claim Denied

Consider these 8 ways to avoid rejected benefit claims. [more]

Travel Planning

6 questions to ask before assuming you are protected by a group plan's travel insurance. [more]

Biologic Logic

Growing list of biologic drugs could bankrupt poorly protected drug plans. [more]

Smart Shopping

8 shopping habits that will protect your benefits plan. [more]

Tough Medicine

Employees will share more responsibilities and higher costs to sustain their benefits. [more]

Crime Costs

5 scams that could be placing your benefits plan at risk. [more]

A Prescription for Your Drug Plan

Skyrocketing drug prices may be threatening your benefits plan, but generic drugs offer a cure. [more]

Planes, Trains and Travel Insurance

The fine print in your travel insurance may leave you more exposed than you think. [more]

Healthy and Wealthy

5 steps to an employee wellness program that will generate real financial returns. [more]

Avoiding Burnout During Holiday Season

Education and Prevention can help control spiraling benefit costs. [more]

Sweat the Small Stuff

Protect your staff by avoiding these common "paperwork" mistakes by administrators. [more]



Services Personal Services Corporate Services