Canada’s new national advocacy body for plan members is preparing to take flight.
The Smart Health Benefits Association (SHBA) already represents 10 million Canadians with workplace health benefits plans (including 4,800 union plans) that are provided by 65,000 employers. The advocacy body’s running start was made possible by its founding members, comprised of four of Canada’s largest benefits advisory firms—GroupHEALTH Benefit Solutions, HUB, Navacord and People Corporation—and Benefits Alliance, Canada’s largest network of independent benefits advisors.
“Until now there hasn’t been a cohesive voice ensuring that policy makers understand the impact of changes on plan members and advocating for the best interests of plan members,” says Mike McClenahan, Vice President, Partner Solutions, People Corporation, and a member of SHBA’s board. “For policy makers especially it’s been very fractured in terms of how they get their information about private health benefits plans.”
SHBA’s board—chaired by Gary Walters, Chief Actuary, GroupHEALTH—first met in April. For now, the membership push will continue to focus on benefits advisory firms to quickly build critical mass and gain the attention of policymakers. An estimated 27 million Canadians currently have private health insurance that supplements the publicly funded healthcare system, states the 2024 edition of the Canadian Life & Health Insurance Association’s 2024 Canadian Life & Health Insurance Facts report.
“We’re calling on all benefits advisors to join and be part of an unprecedented collaboration to improve not only private plans but also access to healthcare for all Canadians, including those who are uninsured or underinsured,” says Walters.
“As benefits advisors speaking to multiple plan sponsors, we are uniquely positioned to explain the plan-member and plan-sponsor experience and bring that to policymakers,” notes Walters.
Details on the cost and benefits of membership for benefits advisors will be released in the coming months. Meanwhile, advisors and plan sponsors can receive regular updates by registering on SHBA’s website.
As Chair of the advocacy working group, McClenahan is prioritizing which issues to tackle first. “At the federal level we have about 10 key issues, including pharmacare and virtual care. And given that health care is a provincial responsibility, that adds another layer,” says McClenahan.
“Big issues can come up very quickly and have a dramatic impact on plan sponsors and their employees. We want to make sure we’re always in a state of readiness and are proactive,” adds Todd Stephen, Vice President, Employee Benefits & Pension, Selectpath Benefits & Financial, a member firm of Benefits Alliance, who is part of SHBA’s advocacy working group.
SHBA’s website states the association “champions a future where all Canadians can afford the healthcare support they need to thrive, without financial hardship.” It three main priorities are:
Advocacy that calls for smart funding approaches—generally where public and private work together—to expand affordable coverage options, and help Canadians manage out-of-pocket health costs more effectively.
Employer support through the evolution of employer-sponsored benefit plans that better address employees’ physical, mental, and financial health needs.
Policy impact with a focus on strengthening financial frameworks, reducing inequities and promoting smart, sustainable, inclusive funding practices in healthcare access.
Stephen, Walters and McClenahan are optimistic that the SHBA will have an impact based on the experiences of its predecessor organization, the Smart Health Benefits Coalition (SHBC). Established in late 2023 to advocate for the benefits of a mixed-payer model for national pharmacare, the coalition successfully arranged meetings with Health Canada, the federal minister of health and multiple other federal ministries, members of parliament, senators and their staffs, culminating in an invitation to present as a witness before the House of Commons Standing Committee on Health.
While legislation for a single-payer national pharmacare nonetheless passed, the SHBC captured the attention of policymakers. “The constant feedback was, ‘We haven’t heard this point of view before,’” says Walters.
The coalition also validated the need for a permanent entity to educate and advocate. “The decision makers aren’t as knowledgeable as they could or should be. And how can they be? Health insurance is a big, multi-tentacled beast,” says Stephen. “We set the stage for better collaboration and the likelihood that when decision makers are debating internally about different health options, they’ll be better positioned to land on better policy due to our knowledge and perspective.”