Women's hormonal health should no longer be a blind spot in the workplace; to achieve this, both employers and insurers have a key role to play. Offering adapted insurance plans, recognizing the impact of these issues and demonstrating flexibility not only supports female employees, but also ensures a healthy, motivated and more productive workforce.
According to Manulife, “Employers can play a key role by developing workplace strategies for women who are experiencing menopausal symptoms, including more comprehensive drug coverage, flexible work schedules, and by normalizing discussions about menopause in the workplace.” These measures could reduce absenteeism at work and prolong the presence of female workers in their jobs.
In its report published last fall on women’s health, Manulife cited a statistic from a report by the Chartered Institute of Personnel and Development (CIPD). In a survey of women between 40 and 60 in the United Kingdom, “17% contemplated leaving the workforce because of insufficient support for their menopausal symptoms, and 6% have left their careers,” according to the CIPD.
For its part, the Menopause Foundation of Canada has published a guide for employers to help them support and properly accompany staff members struggling with menopause. The guide suggests creating an environment that is open and aware of the impact of hormonal disorders, as well as implementing certain accommodation measures, such as a telecommuting policy, greater flexibility in working hours and better insurance coverage to obtain appropriate treatment.
But flexibility must also be tailored to each individual's situation.
Dr. Diane Francoeur, CEO of the Society of Obstetricians and Gynaecologists of Canada, has a professional woman in late pregnancy among her patients.
“She could do her work from home five days a week, but her employer wants her to be on site," explains the gynecologist. “So, my patient was put on preventive leave, which means that instead of having an employee who works, because she's capable of doing so, we're depriving ourselves of a human resource, with the costs that this entails for the organization and the insurer."
Dr. Francoeur believes that common sense should prevail, in this case as in all others.
“Allowing women to have flexible hours, to compensate for the insomnia caused by menopause, for example, would limit the number of absences," she illustrates. “Better still, it will establish a relationship of trust with the workers and win their loyalty."
Insurers are ready, but need to be accommodating
Insurers have noted that their products have kept pace with women's realities and are more flexible than ever.
In Quebec, the documentary Loto-Méno, directed by Véronique Cloutier, removed some of the taboo surrounding menopause.
“It got a lot of people talking,” Eveline Keable, strategic leader, health, wellness and disability at iA Financial Group, told Insurance Portal. In addition to helping to destigmatize this reality, it opened the door to better hormone therapy coverage within several insurance plans."
The diversity, equity and inclusion policies implemented in organizations also have influenced the revision of insurance plans.
“In the U.S., insurers decide which drugs can be prescribed based on diagnosis," explains Dr. Francoeur. In Canada, we use the medication we feel is most appropriate.”
Some drugs are prescribed not for their primary purpose, but for their side effects. “The best example is Misoprostol; it was invented to treat stomach ulcers, but we use it for voluntary termination of pregnancy, or after childbirth and miscarriage,” says Diane Francoeur.
Another example is Metformin, which treats diabetes and is also used to ease the discomfort of polycystic ovary syndrome, because it helps reduce the production of male hormones by the ovaries.
“As soon as I put the diagnosis in a file, my patients confide in me that they're having trouble getting insurance," she adds. “When they see the prescription, insurers assume that they have an increased risk of type 2 diabetes, when this is far from always being the case. I then have to write a letter to the insurer. If the patient doesn't have diabetes or hypertension, she shouldn't be penalized."
Insurers shouldn't worry about this diagnosis, given that its complications tend to subside over time, then disappear with the onset of menopause. “It's not a disease that deteriorates.”
As weight loss can help reduce the symptoms of the syndrome, she wonders about the role of insurers. Should they cover drugs that help weight loss?" she asks. It's a double-edged sword, because the only really effective remedy is to change lifestyle habits over the long term. If insurers invested in improving lifestyle habits, it would help."
Eveline Keable mentions that some insurers and employers are already turning to wellness programs, and some are reimbursing sports equipment expenses. “Often, keeping women active helps their symptoms,” she says.
An evolving product offering
Insurance needs vary according to the age of the insured. But statistics show that women make more healthcare and drug claims than men.
“We are developing services and programs to support women's health through the major stages of their lives, including family planning with coverage for fertility treatments and support services,” explains Jennifer Foubert, Assistant Vice-President, Head of Product, Group Benefits, at Manulife.
For young adults, the needs are mainly related to contraception," notes Eveline Keable. “Then there's pregnancy or infertility, which can lead to depression. Later, there's hormone replacement at menopause."
We also note, in terms of disability insurance, that more women experience mental health problems, and that their absence from work is generally longer than that of men.
"Treatment often has to be customized to each individual's response, modifying products and doses to find the optimal fit. These traditional therapies are generally covered by a comprehensive drug insurance plan," says Foubert.
Several insurers have developed specific products for female fertility issues," says Keable. Then it's up to employers to decide whether they want to offer it to their employees, with the costs that this entails," she says.
Both iA and Manulife say they are looking for the best partners to create an offering that meets the greatest number of customer needs.
"We're going to do business with partners offering virtual healthcare, such as an employee assistance program, telemedicine, mental health management programs and cognitive behavioral therapy. This can be good for sleep disorders, hot flashes and other menopause-related conditions," says Keable.
Finally, when certain elements are not included in the group insurance plan, some employers also set up health management accounts; members can then use a predetermined amount on a discretionary basis to obtain services.
What's important, contends Eveline Keable, is that the employer effectively communicates the insurance offering that is available to workers. “That's the key to getting women to use the services available to them,” she says.
Sun Life declined our request for an interview. Canada Life did not respond to our request for an interview and information.