Stay on top of insurance and benefits news

Year In Review 2018: What’s On The Horizon For 2019

With everything that went on in the insurance arena in 2018, I’m proud to see where everything is trending and evolving towards.

Especially when you look at it from a coverage and technology standpoint, some carriers are really adapting faster than others – and it’s actually a win-win for everybody. The exciting challenge is for the advisor to keep up with these developments whether it be in coverage or technology and continue to drive value for plan sponsors.

Here’s a quick snapshot of the big-ticket items that made the headlines in 2018, and what’s on deck for 2019.

Cannabis took centre stage this year

There was an incredible amount of speculation leading up to the legalization of cannabis in October. Fortunately, the insurance industry was well-equipped for this transition with all of the federal, provincial and municipal regulations and anticipating how it would play out in benefits plans.

There was a phase in September where every two days you would get an announcement about new companies getting on board with medical cannabis, because nobody wanted to be on the wrong side of history. What I think will happen going forward is that you’re going to see over time more conditions being covered; because right now depending on the insurance company, they will cover anywhere between 3-5 conditions. The core five conditions are multiple sclerosis, cancer, HIV, arthritis, and palliative care, but you will start to see it built out to become more comprehensive list so more people can be covered.

You’re not going to see it just offered unlimited, and sponsors will be cognizant of the costs of medical cannabis. The Canadian Armed Forces is a good example of this where they had to actually cap it because their medical costs were $10,000-$20,000 per employee per year for the ones that are using it – and it became unmanageable.

Companies will start to cover more in 2019, but there will be limitations as to how much they are willing to cover.

What’s going to happen with a national pharmacare program?

I think this is going to be a big issue in the next election.

All the major parties are going to talk about a national pharma care program similar to what Australia, Germany and Sweden did. There are two questions I see stemming from this; who is going to pay for all of this, because the costs will be anything between $19-26 billion and how many prescription drugs will actually be covered?

There are obviously provincial plans, and there will be costs associated with it but they could only cover a quarter of the total drugs. The need for private health care plans is not going to go away just because there is a national pharma care program. Costs will go down, but it will still be a requirement to have private health care coverage.

That’s why I firmly believe that all the political parties will pick up on it, but it won’t come to fruition in 2019.

“Doctor in a Pocket” will really take off  

I personally believe that telemedicine will be huge in 2019.

Cognitive behavioural therapy helps remove barriers for people who need support, whether it’s related to geography, cost or specific challenges with anxiety or depression. Many diagnoses do not require a hands-on in-person consultation, and this saves hours in someone’s day.

When you think of someone who just moved to Toronto and do not have a family doctor, (and we know the challenges with getting a family doctor in Toronto,) to have an employer that offers online support will give them access to someone on a fairly accessible basis. This is huge for increasing employee loyalty and productivity.

Understandably, it’s difficult for smaller employers in the startup space to tailor and personalize their coverage, because you are kind of limited to what you can do, but having something as malleable as this to supplement your benefits plan and world-class health care system can do wonders for your young team.

Cognitive behaviour therapy will be more available, with online platforms for psychotherapists so I think you’re going to see a transition online from your traditional model, and a considerable uptick in the next 12 months.

Proposed Amendments to OHIP+

Beginning in March 2019, children and youth who do not have existing prescription drug benefits covered by private plans will continue to receive coverage through OHIP+.

My thinking is that this is happening all too quickly. And while I understand from a fiscal standpoint why the provincial government is promising these cost savings, the timeframe for implementation was kept under wraps for a long time now and there are far too many questions to answer before the end of Q1.

Will the government actually have the necessary systems in place with insurers and pharmacies by late March? Will pharmacists be able to verify whether customers under 25 have private coverage? Will they actually be able to “police” this function? And is the proper IT system in place to handle this?

This is still clouded with complications, and I don’t feel it will be as smooth a transition as we’re led to believe.

Between the massive uprising with Toronto’s tech boom, absenteeism, cannabis legalization and how we approach mental health issues, you have to be able to pivot quickly to adapt to the evolving needs of the modern workforce. And if 2018 has shown us anything, it’s that the war for tech talent will only continue to mount as we flip the calendar.