Presentation to Canadian Assistive Devices Association March 11, - PowerPoint PPT Presentation

Presentation to Canadian Assistive Devices Association March 11, 2015

Agenda • Overview of CLHIA • Group Plans • Challenges • Opportunities

Overview of CLHIA • The CLHIA is a voluntary association representing 99 percent of Canada's life and health insurance business • Approx 24 m Canadians covered through Extended Health Care (EHC) private plans

Key stakeholder in healthcare system • Private health insurance accounts for roughly 13% of total health care spending (16% if we include income replacement costs). • . 2013 Total Direct Health Care Spending ($177.5 B) 2013 Total Direct Health Care Spending ($177.5 B) Income Income Government Government Private Supplementary Health Private Supplementary Health Replace't Replace't ( excl. Capex, Public Health, Admin, etc ) ( excl. Capex, Public Health, Admin, etc ) ($20.0 B) ($20.0 B) ($6.9 B) ($6.9 B) ($148.6 B) ($148.6 B) Paramed Paramed & Other & Other Hospita Hospita Hosp Hosp Other Other Vision Vision Travel Travel Healthcar Healthcar Dental Dental Physician Physician STD STD LTD LTD l l Drugs Drugs Drugs Drugs e goods e goods ($60.7 ($60.7 ($44.0 ($44.0 Care Care Ins Ins Care Care s ($31.8 B) s ($31.8 B) ($1.2 B ) ($1.2 B ) ($5.7 B) ($5.7 B) Accom Accom ($9.7 B) ($9.7 B) and and $12.1B $12.1B B) B) B) B) ($1.3 B) ($1.3 B) ($692 M) ($692 M) ($7.0 B) ($7.0 B) ($1.6 B) ($1.6 B) services services ($1.7 B) ($1.7 B) Source: CIHI, CLHIA Employers balance all of their benefits to attract and retain employees, as well as to ensure a healthy and productive workforce 4

Group Benefit Plan considerations • Offering benefits is voluntary for employers • Private plans are supplemental to public plans • Rising employee benefit costs are creating concerns regarding the sustainability of plans • Fraud and abuse contributes to cost concerns • Employers seeking more aggressive cost management • Medically necessary services or supplies

Assistive Devices: Challenges • New products/technology • Determining usual and customary

Assistive Devices: Opportunities • Creating awareness of ongoing developments • Working together

Questions???