Prescription drugs are usually the most claimed item in a benefit plan. When addressing ways to reduce the claim cost for drugs, it’s important to remember why the drug coverage is being offered. A group benefits plan has three purposes. First it protects employees from a catastrophic loss due to health. This is insurance. Today, even common chronic conditions like high cholesterol can cost almost $10,000 per year; this firmly places drug coverage in the insurance category. Second, it acts as compensation with coverage for day to day expenses like dental, vision and health services like massage. Third, the plan supports employee’s health in a preventative manner.
 
Keeping in mind that drug coverage is insurance, I have categorized solutions into four buckets.
 
Bucket #1: Plan Design
There are two basic plan design features that should be part of every plan:

• Mandatory generic or lowest cost substitution.
• Prior Authorization for specialty drugs.

 
Other plan options:

• Favouring biosimilar drugs (this is something that is happening on a provincial level and options vary by insurer).
• Drug Formularies.
• High deductible plan combined with a healthcare spending account.

 
It may be tempting to put a maximum on drugs. Avoid this if possible. Even a maximum of $50,000 limits the drug insurance and your employee’s ability to access a life saving drug. Drug maximums also pose an ethical dilemma and could be seen as a fundamental change to compensation especially when you have an employee or dependent using a high cost drug. Formularies such as those offered by the Reformulary Group are under utilized ways for employers to keep their drug plan sustainable while encouraging employees to make informed, smart drug choices.
 
Bucket # 2: Increased adherence to medications
Adherence to prescriptions reduces the overall cost of a plan member’s chronic condition, especially those with multiple chronic conditions. One way to increase adherence is with a dispending fee frequency limit (DFFL). This is not to be confused with a dispensing fee cap. The DFFL sets a threshold for the number of dispensing fees paid for by your plan for maintenance drugs only. A DFFL encourages plan members to fill maintenance drugs in three-month supplies which is known to increase adherence to medication

There are other programs that can help increase adherence such as the online pharmacy PocketPills. PocketPills combines personalized packing with technology to manage an employee’s medications. Their system helps employees remember to take their medications as prescribed by their physician, plus they have a low mark up and dispensing fee.
 
Bucket #3: Preventative healthcare
Preventing drug claims from happening in the first place is the best way to keep drug cots low. Many chronic conditions can be prevented with lifestyle and fostering a culture of wellness. Focusing on mental, physical and financial health will positively impact your claims. Many insurers have free wellness programs and mental health support built into your plan for free.
 
Bucket #4: Education
 Do you and your employees know about the programs available to you from your insurer?
What programs does your local pharmacist offer? What about online and mail order pharmacies?
What do employees know about shopping for the best price for prescriptions?
Do employees know how to manage their conditions?
Are employees using the technology provided by the insurer?
 
Insurers have built in a lot of resources, programs, and tools for employees. But employees can’t utilize these if they don’t know they are there. Ask your advisor what your insurer offers and have an employee communication strategy.

Firstly, it’s important to cover why protecting employees’ mental health is so important. Why should employers care enough to protect their employee’s mental health? After all, the workforce is changing and employee loyalty is waning. Ultimately it’s the right thing to do, but there is also a strong business case to be made for protecting employee mental health. 

According to the Canadian Mental Health Association (CMHA) half of Canadians will have suffered from a mental illness by age 40. Mental illness is also a leading cause of disability in Canada, accounting for 30% of claims and 70% of all disability costs. Given that the cost of disability leave for mental illness is about double the cost of a leave due to physical illness, that’s a significant impact to employers. Mental illness is also often an underlying secondary cause of disability when physical illness or accident is the primary cause. 

And that’s just the financial tip of the iceberg. Laying underneath is the cost of presenteeism and absenteeism that poor mental health can have on a business.

So – back to the original question: what can employers do?

There is a lot to consider when it comes to mental health and many employers may not know how or where to start. Here’s what I recommend to begin:

Employers can start by reviewing the Centre for Addiction and Mental Health (CAMH)’s Mental Health Playbook for Business Leaders. The playbook outlines five research-informed recommendations for employers to begin bringing mental health to the forefront.

I also recommend reading about the National Standard for Psychological Health and Safety in the Workplace– “the first of its kind in the world, is a set of voluntary guidelines, tools, and resources intended to guide organizations in promoting mental health and preventing psychological harm at work”.

Employers can also access resources from Not Myself Today, including an informational kit to help them get started!

Include Mental Health in Employee Benefits

It’s common practice for employers to incorporate support for mental health in their total compensation strategy, namely in the benefit plan. The Employee and Family Assistance Program (EAP) is something that many employers may already be familiar with. The EAP supports employees to resolve work, health and life issues. The EAP is an effective, but underutilized product. A newer tool in the benefits box is iCBT or internet-based Cognitive Behavioral Therapy. iCBT is digital therapy guided by a registered mental health professional. iCBT can be claimed through the psychologist benefit in most benefit plans. 

Other ways that employers can support employee mental health through their total compensation package, is to include generous time for personal days. Notice that I didn’t say sick days. Stigma around mental health is still an issue and the language we use to break down stigma matters. Allocating personal days to employees gives them the flexibility to take a day off, whether it be for a physical or mental illness. Removing barriers to access care and time off, such as a doctor’s note, is an easy change that employers can implement right away.

Build Support from Top-Down

Beyond the basic support available to employees in their benefits, building support for employee’s mental health must come from the top down. Leadership must be invested in supporting employee’s mental health and they must practice what they preach. Otherwise programs fall flat, and employees won’t buy what leadership is selling. Ultimately the support needs to be part of the company culture. 

Employers should be careful not to confuse supporting employee wellness with employee mental health and mental illness. Workplace wellness initiatives usually support healthy behavior in the workplace with the goal of improving health outcomes. These programs may include activity challenges, flu clinics, gym memberships, lunchtime yoga or mindfulness and more. Wellness initiatives can support mental health, but it is in a separate category from mental health initiatives.
When it comes down to it, little budget, big-budget, or no budget there’s something every employer can do to support employees and their mental health.

This article was originally posted on February 25, 20202 in the Benefits by Design Ask the Advisor segment.

It’s week two working from home for many of us and may have been a difficult transition for lots of people. I have been home based (more than once) for two years and manage a sales team. Here are five tips about how to thrive working from home. 
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1.     It’s true what they say, keep your usual morning routine: wake up, shower, eat, run, yoga, meditate, read the news (maybe skip this for now), make lunches, whatever. Do that. But most importantly commute. I mean it. By leaving the house and taking a quick walk around the block, you give your brain the chance to reset and get into the right mindset for work. This will also help separate your home from your “office”.
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2.     Take breaks and don’t forget to eat. Some of you may need to hide the chips. I actually struggle with both of these!

3.     Get outside at least once per day.
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4.     Pick up the phone instead of emailing and embrace video chat.

5.    Shut down your tech completely and put your work away. If you can see your work, it will be difficult to transition back into home life. Then “commute” home. Just like the commute you did into your work mind set, leaving the house and walking around the block will let you decompress your workday.

Bonus: Know your peak productivity time and your peak unproductive time. My peak productivity is morning until lunch. During my productive peak I do all my “pay yourself first” activity and tackle my most important tasks. For my unproductive periods I schedule email time, admin work, and I used to book face to face meetings, now I book zoom meetings.