Stigma prevails

in the workplace,

and across

the country

It seems Canadians still have a lot of work to do before we areable to shake off some of the popular, long-held misconceptionsabout mental illness. And to help us along, the federalgovernment has committed $130 million to the effort overthe next 10 years.

On August 18 when Tony Clement, the former minster of health, announced the

funding for the Canadian Mental Health Commission, the Canadian Medical

Association (CMA) released its 8th Annual National Report Card on Health Care. The

CMA report contains some insight into the way Canadians perceive mental illness, and

how they interact with people who suffer from it.

Even though 90 per cent of people agree that mental illnesses are like cancer and

diabetes and require treatment by a doctor, we also attach fears to mental illness that

people with diabetes and cancer aren’t likely to encounter. In the survey, a quarter of

the people asked agreed with the statement, “I am uneasy when I am around someone

who has a mental illness,” and 27 per cent agreed with the statement, “I would be

fearful being around someone who has a serious mental illness.”

BenefitE M P L O Y E E

newsinsideMental health 1-3

More organizations offeremployee benefits 4-5

eBenefit News 6

The Script 7

Wilson Banwell becomesHuman SolutionsTM 8

Legislative update 8

VOLUME 15 • ISSUE 4QUARTERLYFOURTH QUARTER 2008

Mental health

2

This stigma carries into the

workplace. Less than half (49%) of

the people surveyed indicated they

would be willing to socialize with co-

workers who have a mental illness.

People who are clinically depressed

or who suffer from one of the more

serious mental illnesses (for example,

schizophrenia) have even less

likelihood of finding a co-worker

who is willing to socialize with them

(43% and 35% respectively).

Professionals who suffer from the

condition face an even bigger

challenge: winning customers. The

overwhelming majority of Canadians

said they are unlikely to hire a

landscaper, financial advisor,

childcare worker, lawyer, or family

doctor with a mental health

condition. This attitude no doubt

contributes to many mental illness

cases going unreported,

undiagnosed, and untreated.

This was illustrated by a survey of

567 psychiatrists in the United

States, where researchers found that

15.7 per cent had treated themselves

for mild depression, and 43 per cent

said they would be likely to self-treat if

they developed the condition in the

future. Psychiatrists said their actions

were motivated by the desire to keep

a clean health insurance record, and

worries about the stigma that mental

illness carries.

Younger people less likelyto talk about mental health

The CMA survey asked people how

open they would be if someone in

their family became sick. Almost

three-quarters of the people surveyed

said they would talk to their friends

and co-workers if a family member

was diagnosed with cancer. Slightly

fewer would speak to their friends

and co-workers about a family

members’ diabetes (68%), and exactly

half of the people asked said they

would speak with their friends about a

family member with a mental illness.

Of the group of people who are

willing to discuss their family

member’s mental illness, the younger

age group (between the ages of 18

and 34) was found to be the most

uncomfortable discussing the issue,

despite the fact that younger people

are at a higher risk for developing

mental health issues. And men were

considerably more hesitant than

women to talk about the subject.

80%

70%

60%

50%

40%

30%

20%

10%

0%Doctor Family Boss

73%

58%

23%

Talking about our own mental healthSurvey respondents were asked about their willingness to talk to different groups

of people about their own mental health.

“If I thought I had a mentalillness I would feelcomfortable talking to…”

Younger people are less likely to speak

to their family doctor (36%) compared

to people between 35 and 54 years of

age (48%) and those 55 years of age

and older (60%).

Completely or somewhat agree

Let’s face this

In October, Manulife Financial

supported an innovative, web-

based awareness and fundraising

campaign by Sunnybrook Health

Sciences Centre in Toronto, a

leading neuroscience treatment

and research facility. The

campaign was conducted during

Mental Illness Awareness Week

and encouraged visitors to post

a photo and a message on the

campaign site

(www.letsfacethis.ca). Posting a

photo and making a donation

was a way for Canadians to

‘face’ the issue of mental illness.

3

Sources: Canadian Mental Health Association; Canadian Medical Association, 8th Annual National Report Card on Health Care; Mental Health Commission of Canada(http://www.mentalhealthcommission.ca); Balon, R. (2007) Psychiatrist attitudes toward self-treatment of their own depression. Psychotherapy and Psychosomatics, 76, 306-310.

Responding to mentalhealth issues in theworkplace

To address mental health issues and

overcome the stigma that persists to this

day, Canadians need easy access to

education and resources. And the

workplace is a good place to start.

When a plan member is struggling with

a mental health issue, managers and

employers can make significant

contributions to how well the employee

deals with, and recovers from, the

illness. This is especially true when the

manager is trained to support or

accommodate the employee, and when

the workplace policies include an active

approach to preventing and managing

absences arising from mental illness.

People’s identities are strongly

connected to their jobs and careers.

Work is a healthy part of life and

provides financial rewards and

independence, as well as personal

satisfaction and a sense of self-worth.

When dealing with a mental health

issue, recovery can be supported when

the plan member maintains the

connection to work and peers, with

workplace accommodations (such as

pace of work, flexibility in hours, or

adjustment to various functions) where

necessary. Employees need to know

they can approach their manager or

employer for positive support and

information, without the fear of

workplace repercussions.

Questions for plan sponsorsto ask themselves:

• Do my plan members (employees)

know about the health care

resources that are available to them

through their workplace or group

benefits plan?

• How does my Employee Assistance

Program (EAP) address situations

where plan members have a mental

health diagnosis?

• Do my EAP, disability, or absence

management programs support

plan members and help them

remain on-the-job as long as it is

healthy for them to do so?

• Following an extended absence

from the workplace, are plan

members sufficiently educated

about the resources available to

support their healthy and successful

return to work?

Practical tools and resources

Manulife Financial recently launched

Workplace Solutions for Mental Health,

a comprehensive mental health strategy

that includes a web-based resource

centre (www.manulife.ca/groupbenefits).

The goal is to help plan sponsors and

plan members achieve better mental

health outcomes by providing

knowledge, tools, and links to credible

resources in the community.

Workplace Solutions for Mental Health

was built in collaboration with some of

the leading organizations in the mental

health field, and is guided by an advisory

board of notable experts. Visit the site

today, then encourage your plan

members and their families to access the

ever-growing library of resources

concerning ways to address the subject

of mental health in the workplace.

The next ten years

The Canadian Mental Health

Commission, the body that received

the federal funding in August, is acting

to change Canadians’ perceptions and

attitudes concerning mental health

and mental illnesses. Over the next 10

years, the Commission will execute a

campaign aimed at ending the stigma

associated with mental health. It will

also build a Canadian knowledge

exchange centre, develop the country’s

mental health strategy, and seek out

ways to help homeless people in

Canada who are living with a mental

health condition. Through these

efforts, and others, the next decade

may see mental health being brought

into the open where it can be more

readily discussed, more easily treated,

and better understood by Canadians.

More organizations offeremployee benefitsMore companies covering more CanadiansStatistics Canada has released some of

the findings from its six year long

Workplace and Employee Survey.

One of the subjects looked at by the

Workplace and Employee Survey was

the prevalence of ‘non-wage benefits’ in

Canadian workplaces. Non-wage

benefits include things such as health

coverage, retirement programs, paid

vacations, performance pay, and other

employee assistance plans. Over the

course of the survey period (1999 to

2005), the number of workplaces

providing non-wage benefits rose by

over six per cent, giving almost three-

quarters of all Canadian workers (74%)

access to at least one non-wage benefit.

Health coverage leadsthe pack

Health benefits plans are the most

common type of non-wage benefit in

Canada. Fifty-nine per cent of workers

have life and disability insurance, 56 per

cent have dental plans, and 51 per cent

have supplemental medical insurance.

The Workplace and Employee Survey

says that women, young workers, and

those with less than a high school

education are the least likely to have

access to any non-wage benefits.

Full-time workers, people who are in a

union or working under a collective

bargaining agreement, and employees

of larger organizations, are more likely

to receive benefits. Nine out of 10

professional workers have programs.

By field of employment, the retail and

consumer services fields are the least

likely to offer benefits (54.6%). At the

other end of the spectrum, most people

working in the financial and insurance

industries have access to non-wage

benefits plans (90%).

Benefits plans: drillingdeeper

In the 2008 sanofi-aventis Health Care

Survey, an annual survey of Canadians

with an employer-sponsored group

benefits program, respondents made it

clear that their health benefits are an

important part of their overall

compensation package. And while plan

members’ preferences about the

features of the plans were found to be

changing, the vast majority reported

they are still satisfied with their

programs.

One suggestion that the sanofi-aventis

survey’s advisory board found worthy

of discussion was the idea that plan

members whose incomes are below a

certain level should pay less for their

group benefits plans. This concept was

supported by 63 per cent of survey

respondents.

“If the out-of-pocket cost gets too

high, study after study warns that

individuals won’t take their drugs.

Obviously, that affects their health,

their stress, and their productivity,”

warns Ron Gathercole, a member of

the survey’s advisory board. A change in

plan design that may seem trivial to the

higher income employee could tip the

balance for the lower wage earner.

Gathercole says, “For some employees,

the difference is immense, and plan

designs now need to reflect this.”

Who’s offering what?

Source: Statistics Canada,Workplace and Employee Survey

4

Non-wage benefit Organizations offering

Paid vacation 85.7%

Life and disability insurance 59.0%

Dental plans 56.1%

Supplemental medical insurance 51.3%

Performance-related pay 36.9%

Personal and family support programs (EAPs etc.) 33.3%

5

It’s interesting that when asked the

question, “What can your employer do

to demonstrate to you that the

organization really cares about its

employees’ health?” the most common

response was “I don’t know/no

response” (22%). This might be an

indication that employers’ current

efforts are meeting their plan members’

needs. Although, can you ever really

say, “I care” enough?

What plan members want

One area where plan members were

much more specific was on the subject

of “What type of plan do you prefer?”

When asked to choose, 65 per cent

asked for a flex plan, although only 29

per cent currently have one. On the

opposite side of the equation, only 15

per cent indicated a preference for

traditional plans even though over half

of the people surveyed (53%) currently

have a traditional style of benefits

program with no plan member choice

when it comes to coverage.

Based on these answers, it’s not

surprising that the plan members with a

flex plan or a Health Care Spending

Account were more likely to rate their

programs as “excellent” or “very good”

compared to the scores awarded by

members with a traditional plan.

Non-wage benefits are an important

aspect of employment for a growing

number of Canadian workers and their

families. Employee surveys such as the

ones discussed here can help employers

meet the challenge of finding the right

mix of benefits and incentives that

respond to the wants and needs of plan

members, while also meeting the

objectives of the organization.

With more employers offering benefits to more Canadians, are planmembers responding with greater levels of loyalty, engagement, andproductivity? The sanofi-aventis survey found high levels of satisfactionamongst the plan members surveyed.

Consider the following statements Do you agree?

“An employer who spends company time and resources on health benefits and preventive

health programs shows its employees it really cares about them.”

• 94%

“I am satisfied with my job.” • 90%

“If I really believed my employer cared about my health and helped me prevent disease,

illness, or injury, I would be more likely to stay with my employer.”

• 83%

“My employer really cares about my health and well-being.” • 74%

“I think my employer is doing enough to promote health and disease,

illness, and injury prevention.”

• 71%

Sources: Statistics Canada, The Daily, catalogue 11-001-X1E, September 24, 2008; sanofi-aventis Health Care Survey 2008

70%

60%

50%

40%

30%

20%

10%

0%Flex Plan Traditional

PlanHealth Care

Spending Account

65%

29%

15%

53%

19% 19%

What type of plando you have?

What type of plan do you want?

You can read the full sanofi-aventisHealth Care Survey athttp://www.sanofi-aventis.ca

“What planmemberswant” versus“What planmembershave”

Source: sanofi-aventis Health Care Survey 2008

Source: sanofi-aventis HealthCare Survey 2008

New resources forvolunteer caregivers

Take a quick look around your office,

your lunchroom or the factory floor.

Scan the faces of your co-workers.

There’s an excellent chance that at the

end of a long day at work, some of

the people you see step out of the

workplace and step right into the

role of caregiver when they go home

at night.

That’s the daily routine for as many as

three million ordinary Canadians.

These are the people involved in

delivering valuable health care services

to spouses, children, aging parents,

and even friends and neighbours.

Connecting caregiversacross the country

Recognizing the importance of family

and friend caregivers, and the daily

challenges faced by people who find

themselves in the role, VON Canada

has launched a website called

“Caregiver Connect…from Caring to

Sharing.” The website

(www.caregiver-connect.ca) is both an

information centre for caregivers and a

forum where they can exchange

stories and draw support and strength

from others who find themselves

caring for an ailing loved one.

Dr. Judith Shamian, president and CEO

of VON Canada says, “Caregivers are

an essential part of the Canadian

health care system – providing over $5

billion in savings on health care costs.”

But without support, those savings can

come at a high price for the caregivers,

putting strain and stress on them

physically and emotionally. So the new

site serves the dual purpose of

equipping caregivers to provide a

better quality of care to their family

and friends, while helping to protect

their own quality of life and equipping

them to deal with the demands they

face each day.

Sites such as Caregiver Connect can

help your plan members uncover

resources, access the latest information

and gain insight into the services

available to them as caregivers,

regardless of where they live. In many

ways, Caregiver Connect complements

Manulife Financial’s own Health Service

Navigator® tool. Health Service

Navigator helps plan members

navigate the Canadian health care

system following the diagnosis of an

illness or serious health condition. It

includes a ‘chronic conditions centre’

featuring a community support group

data base that can be searched by

‘condition’ and ‘province’.

As some of the stories on Caregiver

Connect suggest, despite the

challenges and the stress that caring

for an ill or disabled loved one often

involves, when caregivers have the

information, resources and support

they need, the responsibility also offers

many meaningful moments and deeply

satisfying rewards.

Health Service Navigator® is offered throughManulife Financial (The Manufacturers LifeInsurance Company).

Source: Canada Health Infoway

eBenefit News

6

Topics available onCaregiver Connect:

• Information on healthconditions

• Links to government programs

• Information on ‘working andcaregiving’

• Information about legal andfinancial assistance

• Home care programs

• Caregiver discussion forums

• Expert blogs

7

The Script

Prior authorization

Prior authorization is a standard claims

management process that insurance

companies use in order to make sure

your plan is only paying for drugs that

are eligible under the plan’s contract.

The prior authorization process requires

a plan member to submit additional

medical information from his or her

physician when the physician prescribes

certain drugs. The information must be

received by the insurer before the claim

can be considered.

For example, if one drug can be used

to treat two different medical

conditions, one of which is eligible

under your plan and one which is not

eligible, the insurance company will

use the prior authorization process to

gather additional medical information

from the plan member and the

prescribing doctor. This makes sure

that the drug is being used to treat the

specific medical condition that the

plan is intended to cover.

Why would a drug not becovered?

There are a variety of different reasons

why a drug might not be covered by a

benefits plan.

• If a drug is administered in a

hospital, the drug should be paid

for by the hospital, so claims for

these drugs are automatically

declined. In the same way, if a

federal or provincial government

drug program covers the cost of a

medication, the claim is declined

because the plan does not cover

drugs that can be paid for by a

government program.

• Experimental or investigational drugs

are declined because the plan only

covers drugs that Health Canada has

already approved for use.

• If a drug is being used for a

cosmetic purpose, the expense is

declined because the plan only

covers expenses that are medically

necessary for the treatment of a

sickness or injury.

• If a benefits plan has been set up

to exclude a certain therapeutic

class, the insurance company will

exclude the drug and all claims

would be declined.

ESI Canada is a registered trademark of Express Scripts, Inc.

Claims controls

You can read Manulife Financial’s edition of theESI Canada 2007 Drug Trend Report on our website.Go to www.manulife.ca/groupbenefits and look under theheading ‘What’s New.’

Information for plan members: What to do whenprescribed a drug requiring prior authorization

1. When a claim for a drug that requires prior authorization is

submitted to Manulife Financial, the pharmacist receives a

message indicating that you, the plan member, must get prior

authorization before the claim can be paid. Or, if you submit the

claim yourself, you will receive a letter requesting additional

information to help the insurance company determine the

eligibility of the drug.

2. You must contact your doctor to get the information that is

required and then submit it to the insurer.

3. If you receive approval for the claim, the insurance company will

record the information on its system so that future claims for the

approved drug will be processed the next time the same type of

claim is received. Once a drug has been approved by the prior

authorization process, you don’t need to submit the medical

information every time you submit another claim for this drug.

Please Note:Employee Benefit News is published

to provide information about current

issues and assist in the decision-making

process. Our articles however, are not

intended to provide medical, financial

or legal advice and any queries you

may have should be directed to an

appropriate professional advisor.

For further benefit information,

please call your usual Manulife

Financial contacts.

Employee Benefit News is

published by:

Manulife Financial

Group Benefits

380 Weber Street North

Waterloo, Ontario N2J 4V7

Please send your comments and

suggestions to the EBN editor

by fax: (519) 883-0406.

Extra! Extra?

Plan sponsors and advisors can download

additional copies of this Employee Benefit

News or previous issues from the

‘Newsletters’ page on Manulife Financial’s

website at www.manulife.ca/groupbenefits.

Ce bulletin est égalementpublié en français.

Manulife Financial’s Group Benefits website

at www.manulife.ca/groupbenefits provides

information about group products and

services, industry and legislative issues and

our Regional Group Offices.

Employee Benefit News is offered throughManulife Financial (The ManufacturersLife Insurance Company).

©2008 The Manufacturers Life Insurance Company.All rights reserved.

Manulife Financial and the block design are registeredservice marks and trademarks of The Manufacturers LifeInsurance Company and are used by it and its affiliatesincluding Manulife Financial Corporation. ManulifeFinancial is not responsible for the availability or contentof external websites.

(12/2008)

Wilson Banwell becomes HumanSolutions™

In October, Wilson Banwell PROACT Human Solutions™ changed its name to

Human Solutions™.

Wilson Banwell is the provider of Manulife Financial’s Resilience® employee

and family assistance program. Through a series of recent mergers, the size

and the name of the company had grown. The new name is easier for plan

members to use and remember, and better captures the values and vision of

the organization.

The name change does not affect the Resilience product in any way.

Resilience® is offered through Manulife Financial (The Manufacturers Life Insurance Company).

Legislative update

Prince Edward Island - The Government of Prince Edward Island will pay the

cost of transporting patients to hospitals outside of the province, provided

the patient is referred by his or her physician.

Previously, patients were required to pay $150 for an ambulance trip to

hospitals in Moncton, Halifax, Saint John, or Fredericton. The actual cost of

the ground transportation ranges between $550 and $800 per trip. Patients

paid $750 for air transport; actual costs range from $6,500 (plane) to

$10,800 (helicopter).

Patients no longer need to pay a fee. While these plan member fees were

eligible expenses under private group benefits plans, the relatively small

number of trips made each year is not likely to result in any significant

savings for plan sponsors.

Source: Canadian Life and Health Insurance Association

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