Rethinking Gender: How Benefit Plans, Sponsors and Trustees Can—And Must—Adapt

Alyssa HodderMarch 15, 2023March 15, 2023

How does the move toward greater diversity, equity and inclusion (DEI) impact benefits plans? It’s a game changer, but there are still hurdles that the group insurance industry needs to overcome.

A panel at the International Foundation’s Canadian Health and Wellness Innovations conference explored some of the issues and opportunities. The panel included subject matter experts such as: Karen DeBortoli, Principal, Director, Knowledge Resource Centre and Canadian Privacy Officer at Buck; Jennifer Taylor, Director of Diversity, Equity and Inclusion with Medavie Blue Cross; and Padraigin Murphy, associate at Koskie Minsky LLP.

Recognizing Diversity

While incorporating diversity is increasingly becoming a “must-have” for the next generation of workers, “a lot of people are doing DEI at the side of their desk,” said Taylor, noting that while 70% of organizations have a focus on DEI in the workplace, few have a DEI strategy. It’s important for employers to consider the needs of transgender and non-binary employees, who may be facing fear, stigma and discrimination in the workplace, she explained. In fact, according to survey data, 45% of transgender and non-binary members said they have experienced having one or more unmet health need.

Taylor suggested the following best practices for employers and plan sponsors:

Using inclusive language
Having a broad lens when building products and services
Carefully considering who you consult when you make decisions around gender
Appropriately training your staff.

“Education is extremely key,” she added.

Providing Access to Care

When it comes to health care, all jurisdictions forbid discrimination based on “prohibited grounds”, which include sex, sexual orientation and gender identity. However, there are carve-outs for insurance and pension plans, permitting differential treatment in certain cases, said DeBortoli.

An individual’s ability to access gender-inclusive benefits—in terms of funding, requirements and wait times—depends largely on what is available in their province of residence, she explained. That’s why employers and plan sponsors play a critical role in ensuring gender is recognized and accurately represented in benefits plans and related materials, she added.

Plan sponsors can support employees by providing coverage for gender-affirming care such as hormone therapy and surgical procedures (e.g., hysterectomies, vaginoplasty, tracheal shaving and facial feminization). They may also consider additional mental health supports since these are often lacking or insufficient, said DeBortoli, noting that “gender-affirming care is life-saving care.”

Knowing Your Insurer’s Practices

From a group insurance standpoint, treatment of gender can vary widely, DeBortoli explained, providing results from an informal survey of insurers in 2021/22. For example, while all insurers use (or can accommodate) gender-neutral language, not all use unisex rates for those individuals who select other than male/female. And while providers may cover gender-affirming care, that doesn’t necessarily mean they will cover mental health supports outside of the core benefits plan, she added.

With all this in mind, three key takeaways for plan sponsors are as follows:

Ask your insurer about their practices around capturing and applying gender.
Consider adding gender-affirming care.
Make sure your plan documents and communications are inclusive, and be ready to make changes if they aren’t.

“It’s not if but when this will impact your plan,” DeBortoli affirmed.