Once you understand your priorities and resources, it’s time to review the options available to you. There are both broad and targeted solutions that can help diversify your group benefits plans. You can use a combination of enhancements to meet plan member needs.
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Workplace Benefits DE&I Playbook
- Broad solutions
- Targeted solutions
We understand it can be overwhelming to consider adding niche products for different plan member demographics. Broad solutions are a great starting point. There are many enhancements you can make to your existing plan that will benefit a wider plan member population. You can also implement many of these solutions without significant impact to the cost of your plan.
Broad solutions are about diversity and inclusion – helping plan members see their needs reflected in their benefits plan and fostering their sense of belonging to your organization.
There are many enhancements you can make to your existing plan that will benefit a wider plan member population.
Mental Health
Mental health coverage is important to everyone. However, those from diverse communities experience significant mental health challenges, including more persistent and severe symptoms:
- Suicide rates are up to 9x higher for Indigenous people in Canada2
- Members of Black communities are 20% more likely to experience serious mental health problems than the rest of the population.3
- Members of Black, Asian, and Latin communities receive mental health treatment significantly less than those not belonging to a diverse community.4
- Members of the LGBTQ2+ communities are twice as likely to experience a mental illness. They’re also almost 4x as likely to experience serious mental illness. And twice as likely to have substance use disorders, compared to adults belonging to sexual majority.5
Several factors contribute to this:6, 7, 8.
- systemic racism and discrimination
- cultural stigma
- barriers to care, and
- a lack of access to mental health practitioners who reflect their communities, share similar lived experiences, and can provide culturally relevant care.
Providing access to culturally appropriate mental health support to those from diverse communities is critically important. Review your contract to see what type of mental health providers are eligible under the paramedical benefit. Opening it up to wider range of provider types will improve opportunity to find a culturally relevant provider. Consider adding providers such as psychotherapists and clinical counsellors. It’ll also reduce barriers in accessing care.
Ensuring your plan has adequate mental health coverage is also critical to the health of your diverse plan members. Review your current maximums. The Canadian Psychological Association recommends providing a maximum of $3,500 to $4,000 per individual per year for mental health care. If your mental health maximum is combined with other paramedical providers, consider separating them. If your claims utilization data shows your plan members aren’t making use of these benefits, consider creating a mental health strategy or modifying your communication approach.
Sun Life’s Mental Health Coach offers organizations an innovative and personalized mental health care solution. It focuses on removing barriers to care (cost, access, stigma). It’s tailored to plan member’s diverse needs and preferences. This includes finding culturally relevant care, practitioners of a specific gender, cultural or ethnic background or a member of the LGBTQ2+ community and virtual or in-person practitioners.
Culturally relevant care, sometimes called culturally appropriate or culturally responsive care, is the intentional and consistent decisions made by health-care providers to see, respect, and celebrate the aspects that make up their patients’ unique social identities. (For example, race/ethnicity, gender, sexual orientation, disabilities, socioeconomic status, and religion are types of social identities.) Our culture is a part of our experience, and it shapes how we see the world, react to situations, and interact with others. Culturally responsive care recognizes that and adjusts treatment accordingly.
Optional providers
Access to culturally appropriate practitioners is also important when thinking about physical health. Culture influences where people go for help and who they trust. Some ethnicities may value more holistic practices, such as Ayurveda or traditional medicines.
You can diversify your Extended Healthcare Coverage (EHC) by adding optional coverage for complementary and alternative providers. For example, homeopaths may not be covered on a standard benefits plan. Talk to your account team to make sure you’re offering enough variety in provider types. By combining maximums with other existing benefits, you can provide greater access to diversified, culturally appropriate care without impacting overall plan costs.
Virtual care
Virtual care is another great solution to help diversify benefits. Our DE&I research showed that, across all diverse groups, the most valued services to add to a benefit plan are:
- virtual mental health care, and
- virtual primary care.
From all the diverse groups, our research showed that both services would be most valued by members of the LGBTQ2+ community. However, they provide greater access to care for all plan members, not just those who are part of diverse groups.
Unfortunately, far too many Canadians have challenges accessing primary medical care9, 10, 11.
- 4 in 10 Canadians said that it took them 6+ days to get an appointment the last time they needed medical attention.
- 1 in 6 Canadians don’t have a primary health care provider (1 in 5 for Quebec and British Columbia).
- 40% of Canadians visited an emergency department for timely access to care, despite recognizing their condition could have been treated elsewhere if care had been available.
Virtual primary care is closing the gap around accessing convenient, quality primary care. And Canadians are embracing it. A study by the Canadian Medical Association found that of Canadians who had experienced virtual care:
- 91% were satisfied with their experience.
- 46% said they would prefer a virtual method as a first point of contact for their care.
Similar access challenges exist within mental health care12:
- Over half (54%) of those experiencing mental health issues have not received medical support.
- Affordability (25%) and embarrassment (23%) are the two top barriers Canadians say has prevented them from seeking help.
Sun Life’s virtual care services are powered by Dialogue, offering both primary care and enhanced mental health support. Learn more about our virtual care offerings here.
“I would be okay with my benefits plan costing a bit more
if it offered coverage that was equitable and inclusive. Even if that included services that may not apply to me.”13
It can be hard to know which targeted solution to start with. This is where the voices of plan members matter most. Refer to your Employee Engagement Surveys from the Opportunities and objectives section.
Note: We recognize that this isn’t an exhaustive list. There are many underprivileged groups not listed below. We have chosen to share information for those populations for which we feel Sun Life has comprehensive support or recommendations. As with all DE&I journeys, we continue to innovate in this space. We will update the playbook as new solutions become available.
Pre-natal: Pregnancy can be an exciting time, but also a stressful and expensive. Most serious medical conditions and complications have support within the public healthcare system. However, there are plenty of other ways employers can help. Many of which we’ve already discussed or may already be available on your plan. Consider communicating these benefits to plan members:
- Anxiety surrounding life changes or health, as well as hormone-related depression, reiterates the need for strong mental health coverage.
- Chiropractors, osteopaths and physiotherapists (primarily pelvic floor
specialists) can be vital resources to relieve discomfort and prepare for birth. While coverage is typically standard for these paramedical providers, check your maximums to see if they’re sufficient. - Pregnant people experiencing gestational diabetes could benefit from a Registered Dietician. The dietician can help determine lifestyle changes to naturally improve health outcomes.
- Midwives, birthing centers and pre-natal or post-natal treatment are eligible through our HSA.
- The PSA can help to address pregnancy wellness from all angles. This includes doulas, pre-natal vitamins and herbal remedies, pregnancy literature, and pregnancy pillows.
Post-partum. The time immediately following the birth of a child can be quite challenging. These challenges may include the physical recovery process, hormone imbalances, lack of sleep, significant learning curve and social isolation. In Canada, 23% of women who’ve recently given birth experience post-partum depression or anxiety.18 While plan members may not be actively at work during this time, there are still many ways to support them through your benefits:
- Ensure your plan has adequate maximums and provider options for mental health practitioners. Coverage for virtual visits or online programs can be particularly useful during this time. Sun Life’s virtual care services can help with this.
- Specialized physiotherapists that can help with the physical recovery can be expensive. Check your maximums and considering separating them from other paramedical benefits.
- You can add incontinence supplies to EHC coverage.
- You can add coverage for a breast pump to your eligible equipment list.
The PSA can offer a wide variety of post-partum wellness supports, including:
- parent-and-baby fitness classes
- virtual post-partum rehab workouts
- parenting courses (such as sleep training, baby-led weaning, or potty training)
- childcare
- food delivery services, and
- baby safety equipment.
Climacteric: The 5 years before and after menopause is defined as the climacteric period, which usually occurs in mid-40s to mid-50s. With the onset of menopause and the significant decline in estrogen, a woman’s risk for health conditions such as heart disease, osteoporosis, mood disorders and a range of pelvic floor issues increase. Perimenopause can last 6-8 years. During this time, 3 out of 4 women experience menopausal symptoms that interfere with their daily lives. 10% of women will stop working because their symptoms are debilitating.
Specific products and supports to consider:
- Hormone replacement therapy (such as estrogen and progestogen) is a common treatment to significantly alleviate menopausal symptoms. It also can improve bone density, reduce cholesterol and the risk of diabetes. Check if your benefits plan covers hormone replacement therapy.
- Selective Serotonin Reuptake Inhibitors (SSRI) and serotonin-norepinephrine reuptake inhibitors (SNRI) antidepressants are effective in treating approximately 70% of patients who experience hot flashes and night sweats due to menopause.
- Cognitive Behavioural Therapy (CBT) is becoming a more common, alternative approach to hormone therapy. While it doesn’t alleviate physical symptoms, it improves the patient’s mental approach to coping and dealing with symptoms when they occur. Mental health professionals are generally the ones who provide CBT. Refer to the section on mental health solutions to determine if you should make changes to your plan.
- People who prefer alternative treatments might use:
o soy or plant-based estrogen
o wild yam cream or progesterone cream
o black cohosh or dong quai.
Check your benefits plan coverage as these may be included under a PSA. - Exercise is also very important during this phase of life. A PSA can help support healthy exercise habits.
| EHC | A wide range of medical equipment such as braces, electric wheelchairs, walkers, and scooters. Prosthesis and myoelectric prosthesis for limbs, hips, or eyes. Therapists such as occupational therapists who specialize in promoting a person’s ability to fulfil Speech therapists who can support with speech impairments. Audiologists who can help with hearing impairments and visual therapists with vision impairments. |
| HSA | Various conditions result in disabilities that benefit from a support animal. Some disabilities require modifications to a person’s home to make it more accessible. Persons with disabilities might sometimes require fulltime attendant care. HSAs cover remuneration |
|---|---|
| PSA | Ergonomic assessments can be helpful to persons with disabilities to ensure their workspace In some cases, medical alert products can provide extra pre-caution to individuals with To support with activities of daily living (ADLs), our PSA covers a variety of expenses such as:
|
- Suicide rates are up to 9x higher for Indigenous people
- Of Indigenous people age 12+ living off-reserve:21
o the rate of heavy drinking is 35% compared with 23% for non-Aboriginal Canadians
o and 26-49% smoke daily compared to 15% for non-Aboriginal Canadians - Diabetes rates 2-3x higher for Indigenous peoples living off- and on-reserve.22
Mental health maximums are an important component for healing. However, there’s growing recognition of the importance of providing culturally relevant health care options to Indigenous plan members. Most mental health providers commonly covered by group plans “…are generally not adequately resourced and trained to deal with Indigenous mental health needs.” – Dr. Niigaan Sinclair, Associate Professor in Indigenous Studies, University of Manitoba, consultant to Sun Life.
Providing coverage for culturally relevant treatments, is an important way for organizations to support the health needs of their Indigenous plan members. Such as:
Check out, CAMH’s Aboriginal Services Program, which provides Indigenous patients the option to see a Traditional Elder/Healer and incorporate ceremonies into their treatment program.
- traditional healers and elders
- medicines (e.g. tobacco, cedar, sage and sweetgrass)
- and ceremonies (such as sweat lodges and smudging)
For organizations committed to Truth and Reconciliation, it also helps to meet a key call to action by recognizing the value of Indigenous healing practices through their group benefits plan.23 “We call upon those who can effect change within the Canadian health-care system to recognize the value of Aboriginal healing practices…” – TRC #22
Specific products and supports to consider:
- Sun Life’s PSA offers coverage for traditional Indigenous healing, including elders, ceremonies and medicines.
- We offer an optional benefit which provides rehabilitation coverage for members struggling with substance use.
- You can add smoking cessation products to your EHC plan and eligible through our HSA. Non-prescription options are also covered through our PSA.
- Evaluate your coverage for diabetic supplies, such as glucometers and insulin. Some coverage is usually standard in most EHC plans. However, there may be opportunities to increase maximums or expand eligibility for certain supplies.
- If you have a large rural Indigenous population, they could benefit from our Travel for Treatment benefit. This benefit covers expenses (such as gas, mileage and accommodations) incurred to travel from remote locations to seek public and private medical care.
