Benefits plan sponsors and benefits consultants

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Benefits plan Sponsors and Consultants - Pain Points/Opportunity

Cannabis medications in any form have no drug identification number (DIN) in Canada. Therefore, it is unlikely that sponsors and consultants will include it in benefits plans. Recent Canadian laws allow patients to purchase medical cannabis with funds from their health-care spending accounts, usually financed by employers. However, insurance companies are also entitled to make their own decisions on coverage.

ENGAGING BENEFITS PLAN SPONSORS AND BENEFITS CONSULTANTS TO HELP WITH COVERAGE/REIMBURSEMENT OF MEDICAL CANNABIS BY EMPLOYERS: PAIN POINTS

  • The Canadian Medical Association recently warned its members to proceed with caution, revealing that there is a lack of evidence to support cannabis treatment.
  • A high cost is involved in covering medical marijuana/cannabis and, in many cases, the monetary price is much higher than standard pharmaceuticals. This may discourage Canadian brokers when required to help with the coverage/reimbursement of medical cannabis.
  • Cannabis in any form does not have a drug identification number (DIN) in Canada, so any investigation by employers, sponsors, and consultants into why coverage for medical cannabis does not exist in any benefits plan will most likely end here.
  • Potential employers, sponsors, and consultants in Canada may feel uneasy with helping in the actualization of the coverage/reimbursement of medical cannabis, mainly due to the misunderstanding of the dissimilarities between "medical marijuana and street marijuana."
  • It may be challenging convincing potential employers, sponsors, and consultants in Canada to get involved on legal grounds, as a Canadian court recently held that not covering medical cannabis is not discriminatory according to human rights legislation.
  • The knowledge that human rights legislation won't go as far as requiring private benefit plans to cater to all "necessary" medications and drugs prescribed by doctors, may make sponsors, and consultants, reluctant to engage in the push to cover medical cannabis. Courts have consistently noted that any successful litigation against excluded cannabis medications might give rise to more human rights complaints which will make tribunals become "arbiters of private benefits plans."

ENGAGING BENEFITS PLAN SPONSORS AND BENEFITS CONSULTANTS TO HELP WITH COVERAGE/REIMBURSEMENT OF MEDICAL CANNABIS BY EMPLOYERS: OPPORTUNITIES

  • Potential employers, sponsors, and consultants in Canada might be willing to help once they are aware that some types of medical marijuana do not make their users become "high" as commonly associated with regular marijuana, and employees will not be impaired during use.
  • Canadian employers, sponsors, and consultants can be easily convinced because, like opiates, medical marijuana is used to manage pain. However, unlike opioids, medical marijuana has lower tendencies of making the user addicted.
  • Marijuana is safer than opiates, yet opiates, among other drugs like Contin to Tylenol 3, are already covered under some group drug plans in Canada.
  • Covering medical marijuana in Canadian medical plans is known to be progressive and accommodates the needs of everyone.
  • Potential employers, sponsors, and consultants can easily be convinced that access to medical cannabis isn't new.
  • Consultants and administrators of benefit plans can quickly be convinced to engage in benefits plan sponsorship for medical marijuana once they are aware that Canadian administrators can choose the specific drugs and medications they want to cover.
  • People argue that the coverage of medical cannabis needs to be the norm in Canada, and such coverage for medical cannabis in benefits plans seems to be growing.
  • Sun Life Financial Canada added optional coverage for medical marijuana to its group benefits plans on March 1, 2018, and this example can be used to convince employers, sponsors, and consultants to emulate.
  • Canadian laws allow patients to purchase medical cannabis with funds from their health-care spending accounts usually financed by employers. However, insurance companies are also entitled to make their own decisions on coverage.
  • Some Canadian insurers have started covering medical cannabis in response to rising demand from employees of several firms subscribing to their coverage, and Grocery chain Loblaw recently became the first notable Canadian company to request that its insurers cover medical marijuana.

METHODOLOGY

We scoured through recent surveys and credible media reports such as Canadian Global News, among other websites, to gain insights into the pain points and opportunities when engaging benefits plan sponsors and benefits consultants to help with coverage/reimbursement of medical cannabis by employers. There was no such comprehensive precompiled information uncovered. Insights obtained from Canadian Global News revealed some reasons that Canadian insurers are wary of covering medical marijuana, which we considered vital. According to the Global News report, the Canadian Medical Association recently warned its members to proceed with caution, since there is a lack of evidence to support any treatment using cannabis. We assumed that such open statements which caution doctors against using cannabis and other similar insights may be a pain point for any stakeholder trying to engage benefits plan sponsors and benefits consultants (e.g. brokers) to help with coverage/reimbursement of medical cannabis. The report did not contain any insights that seemed to be an opportunity.

Additional research through legal reports and credible databases such as the Canadian National Prescription Drug Utilization Information System metadata web failed to uncover any insights into the pain points and opportunities when engaging benefits plan sponsors and benefits consultants to help with coverage/reimbursement of medical cannabis by employers. However, research through Benefits Canada web for challenges faced by benefits plan sponsors that cover the reimbursement of medical cannabis by employers in Canada revealed that Canadian laws do not force sponsors to cover medical cannabis but allow them to decide. The fact that the Human Rights Act would not penalize sponsors who do not sponsor medical cannabis was assumed to be a pain point. We also assumed that the high costs of medication using cannabis in Canada may be a pain point when convincing those involved in the decision-making process (such as brokers) to help with the coverage/reimbursement of medical cannabis by employers.

Research through academic journals and credible scholarly research publications, including a publication on Lessons from Cannabis Law published by the University of Ottawa’s Faculty of Law, failed to analyze the pain points and opportunities when engaging benefits plan sponsors and benefits consultants to help with coverage/reimbursement of medical cannabis by employers. Therefore, we researched the advantages of medical cannabis/marijuana to other pain relief drugs covered by benefits plans. A Thorpebenefits web publication revealed that some types of medical marijuana do not make their users go "high" as commonly associated with regular marijuana. The document further revealed that some medical marijuana drugs are safer than opiates, yet opiates such as Contin and Tylenol 3 are already covered under some group drug plans in Canada. We assumed these and other similar insights can be useful when convincing all that are involved in the decision-making process to help with the coverage/reimbursement of medical cannabis by employers.

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