Should Medical Marijuana be covered in your employee health benefit?

Medical Marijuana
Medical Marijuana

Canada is thinking about it and maybe the United States and even the rest of the western world should be thinking about it also; that is including the purchase of medical marijuana in their health benefit plans.

Benefits industry insider Mike Sullivan caught a whiff at a recent meeting with some of his clients, who represent private companies with benefit plans that cover about three million Canadian workers across a range of industries.

“This group that was in attendance, the No. 1 topic of discussion was medical cannabis,” said Sullivan, who is president of Cubic Health, which provides analytics to employers who sponsor health benefit plans.

“That’s what everybody wanted to talk about — but not in a negative way: there’s a lot of support for looking at this and examining it in a thoughtful, responsible way,” Sullivan told an audience at a cannabis business conference held in Toronto by the Canadian Institute May 25.

The insurance industry itself has been hesitant to cover medical marijuana, according to Sullivan.

“Insurance company actuaries cannot get their head around how to price the risk of medical cannabis,” he said, citing the range of products available, the personalized nature of dosing, and the wide range of potential indications as complicating factors.

But that doesn’t matter to medium- and large-sized Canadian employers, Sullivan said. They generally use insurance companies to administer their employee health benefit plans while paying the costs of coverage themselves, an arrangement known as a self-insured, self-funded or “administrative services only” plan.

Self-insured companies get to choose what their benefit plans cover — and apparently, some of their workers want them to cover medical marijuana.

“Employers are hearing it from their employees,” said Joan Weir, director of health and disability policy with the Canadian Life and Health Insurance Association. “Will it ever be a benefit?”

Those employers, said benefits expert Mike Sullivan, are seeking the answer to a question: “Can they do a better job of getting people back to work sooner, and staying at work,” by covering medical marijuana?

“I think it’s a very naive argument for employers to say, ‘Well, we don’t want to open up the door here,'” he said. “The door is already open.”

As self-insured health benefit plans start covering medical marijuana, employees shouldn’t expect blanket approvals for the drug. Coverage will have to be approved on a case-by-case basis, said Sullivan.

Covering medical marijuana brings “mutual benefit” for patients and their employers, according to Jonathan Zaid, executive director of Canadians for Fair Access to Medical Marijuana.

“We hear wide-ranging anecdotal reports that are extremely positive from patients, saying that they’re going back to work, they’re having better family and social lives, they’re happier, their symptoms are more manageable, and they’re often going off of other pharmaceutical drugs which are all insured,” Zaid said.

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