The COVID-19 pandemic hasn’t dampened group insurance activities. On the contrary! Considered an essential service, this sector has been buffeted by accelerating changes.
Whether in terms of travel insurance, employee benefits or telemedicine, adjustments abound. Pivotal market players expect this momentum to continue.
Martin Papillon, CEO of AGA Financial Group, says he is seeing very few plan cancellations among his group insurance clients. “Many of our clients are laying off staff temporarily with no pay to maintain group insurance coverage because they want their employees to come back to work. These employees are receiving financial support from the federal government, which has averted a catastrophe in the group insurance sector up to now,” he told Insurance Portal.
All the same, his group insurance firm has seen a dearth of new clients since the start of the pandemic, Papillon says.
“Setting up a plan and issuing new cards to participants is not easy with no employees. Ongoing files are not being resolved. Employers are waiting to be able to call back most of their employees before going forward,” he explains.
At the peak of the lockdown, temporary layoffs affected nearly 11% of all his clients’ group plan participants. As an essential service, his business dodged temporary layoffs, but 92 of his 95 employees are working remotely.
“The office is technically open because we have to continue to pay claims and collect premiums. Claims adjudication and processing can be done remotely. A few clients are still paying their group insurance premiums by cheque,” he explains.
Travel insurance in the spotlight
Martin Papillon says that at least two components of group insurance will change significantly post-COVID-19: travel insurance and employee benefits offered to laid-off employees.
Owner of the third-party administrator (TPA) and third-party payer firm (TPP), Papillon recalls the tsunami of calls from travel insurance customers during the first week of lockdown. Usually a travel insurance contract is assessed according to the duration limits of coverage, along with whether it includes trip cancellation. During this crisis, insurers used the date that the federal government issued the restriction on nonessential travel, Papillon says. First issued on March 21 for nonessential travel between Canada and the United States, it has been extended until July 21, 2020.
“Insurers told their customers they would be given 10 days to return, or they would lose their coverage. Others said that customers with coverage for 60 days could stay for the duration. But if you cannot go home at the end of 60 days you have a problem,” he says.
Exemption clauses buried in the fine print of a contract become crucial in this time of crisis, he adds. “We will be increasingly vigilant about what is or is not included in a contract.”
“The cost of travel insurance may increase in the coming years because the situation may recur if there is another outbreak.” - Martin Papillon
Among these clauses, the presence of a cancellation guarantee is critical. Insurers are facing prohibitive costs this year due to all the cancellations that occurred during the pandemic, Papillon adds.
“The cost of travel insurance may increase in the coming years because the situation may recur if there is another outbreak, for example next year… Insurers may be more explicit about the restrictions in the contract. They will take more specific positions about the rights and obligations of insured, the duration of coverage, conditions for an early return, etc.,” he explains.
The travel insurance crisis flared early in the pandemic. After it died down, the major question for an employer with a group plan was: What employee benefits should it offer employees who were laid off temporarily when the government put the economy on pause? “We had extensive discussions with our clients about which guarantees they wanted to maintain, and for how long,” he says.
Before the crisis, there were disparities in benefits. “Some clients had contracts with no insurance extension, others extended it 60 days or 180 days,” Papillon adds. “Do clients want to maintain all the coverage or only the health and dental component, excluding disability? Employers need to analyze this.”
Telecare hodgepodge
Telemedicine services are being stoked by the coronavirus crisis, Luc Vilandré, president of TELUS Health and Payment solutions, observes. “The pandemic has heightened the need for virtual health.
“In the end, we will emerge from this pandemic and control the spread of the virus, but for now we are seeing a mixed bag of services.” - Luc Vilandré
For one year, British Columbia was the only province to reimburse telemedicine costs for insured under the public plan, Vilandré adds. When the COVID-19 pandemic was declared, public plans in other provinces began to follow suit, he says. One example is the Québec drug insurance plan. “In the end, we will emerge from this pandemic and control the spread of the virus, but for now we are seeing a mixed bag of services,” he says.
Even when clinics reopen throughout Canada, he thinks that seniors’ homes and long term care centres may opt for virtual services. This move is critical, especially while the virus is being controlled but remains present in the population. “These institutions house a population at risk,” he says.
Virtual clinics will also let patients access healthcare professionals outside of the usual opening hours of traditional clinics. “They will give a real helping hand to redirect patients who otherwise would turn up at the emergency ward because of a health problem that surfaced at 10 p.m.”
Fuelling the digital health infoway?
Luc Vilandré hopes the current situation will convince Canada’s provinces and territories of the merits of a digital prescription platform that TELUS Health and Payment solutions has been trying to set up in cooperation with Canada Health Infoway for over a year. Telus has developed the technology and Infoway is leading the efforts to attract interest in the platform across Canada.
Established in 2001, Infoway is an independent, not-for-profit organization funded by the federal government. The organization acts as an incubator for health technology deployment. Infoway cooperates with clinicians, provinces and territories, the IT community, vendors, academics and various healthcare organizations to highlight the advantages of digital health, its website says. In response to the COVID-19 crisis, Infoway has partnered with the provinces and territories to finance virtual care solutions.
The PresCribeIT platform lets physicians transmit prescriptions that they write electronically directly to the patient’s pharmacy of choice. The pharmacist then serves the patient, and the prescription is automatically transmitted to the adjudicator’s system. “This will close the loop without human intervention,” Vilandré explains.
This tool simplifies the process and reduces the number of errors, he adds. “In Canada there are still thousands of people who die each year due to reactions to side effects of overmedication. In the United States, those numbers were astronomical. The country then made electronic transmission of prescriptions mandatory. In most American states, paper prescriptions are now banned,” Vilandré says.
Errors may occur when a patient obtains three paper prescriptions from different doctors. Physicians cannot view all the information in their systems and detect contraindications, he says.
More work ahead
PresCribeIT is gaining followers as interest in digital prescriptions grows. “We have seen a growing number of digital prescriptions among enrolled prescribers, and a much higher rate of prescribers that want to join our platform,” Vilandré says.
The partners’ aspire to implement the platform throughout Canada. “Unfortunately, there are still many handwritten prescriptions in Canada. Electronic medical files allow it but the physician must often print the prescription to give it to the patient because provincial legislation generally does not allow prescriptions to be sent only in digital mode,” he explains.
The provinces that are open to deployment of PresCribeIT are Ontario, Alberta, New-Brunswick, Saskatchewan and Newfoundland. Québec is still weighing its options, says Vilandré.
“In Québec, the authorities are analyzing whether they want to develop this solution. Because health falls under provincial jurisdiction, sales work needs to be done in each province and territory,” he explains.
