Insights from a pandemic: COVID-19 and group benefits plans

We’ve received numerous questions about the impact of COVID-19 and what it will mean for benefits plans in the months ahead. Below is a summary of what we’re seeing so far. In the coming weeks, we’ll explore each of these topics in greater depth.

Disability

Initially, as COVID-19 started to spread, we saw STD claims ramp up quickly. Since then, we’ve seen the number of COVID-19-related STD claims slow significantly. As for LTD, we believe both the incidence and duration of those claims will increase in both the short term and medium term due to COVID-19.

Health and Dental Claims

We saw an overall spike in the volume and paid amounts for drug claims in March as plan members rushed to stock up on their medications. This was followed by a drop in April after most provinces put 30-day refill limits in place. One exception was claims for asthma drugs which surged in March but had no drop in April. Overall, the April plunge will be short-lived; drug costs have already begun to rise in May.

While paramedical and dental claims are down, we are seeing an increase in claims for virtual treatments and emergency dental services. We expect that claims will spike once the current pandemic restrictions are lifted. We’ve already started to see claims rise in provinces that are allowing health providers to re-open.

Despite the shift to more virtual services, we haven’t seen an increase in fraudulent activity. But we continue to be vigilant. Our investigative practices – verifying with the plan member that they received the treatment and have a valid receipt, and that the practitioner has treatment notes – remain the same whether treatment is provided in person or virtually.

Technology

During this time of physical distancing, people are looking for ways to interact with their providers virtually. Fortunately, our business model is almost entirely electronic, and we have several convenient digital options available for plan members and plan sponsors. Our focus in recent weeks has been to remind clients and plan members about these tools and make it as easy as possible for them to activate and use them. And we are continually adding functionality that will allow us to serve our customers even better.

Mental Health/Wellness

Usage of i-Volve, Homewood’s online cognitive behavioural therapy tool, increased significantly in March before levelling back down in April and May. And while EFAP cases fell in April and early-May, the number of cases has begun to climb in recent weeks, particularly for anxiety. In the coming weeks and months, we expect an eventual increase in marital and family issues, as well as depression. We’ve also seen an increase in mental-health-related prescriptions.

Plan Design

It’s too early to predict how the COVID-19 pandemic will impact benefits plan design and how it will change in the coming months. We would love to get your feedback and insights about how benefit plans will evolve and what new features or provisions they should include.

Please share your thoughts and suggestions with your Group Account Executive or myFlex Marketing Manager. Or, you can email your ideas to GroupCommunications@equitable.ca.