Pubdate: Thu, 15 Feb 2018
Source: Globe and Mail (Canada)
Copyright: 2018 The Globe and Mail Company
Author: Clare O'Hara
Page: A3


Company is gearing up to include medicinal cannabis under extended
health-care benefit plans, helping offset costs for users

Sun Life Assurance Co. of Canada will become the first major insurance
company to add medical marijuana to its group benefits plans for
Canadian companies, a pivotal move in the insurance industry that will
help ease the financial burden for medical marijuana users, and a sign
of the growing acceptance of cannabis in the Canadian workplace.

As of March 1, Sun Life will include medical cannabis as optional
coverage under an extended health-care benefit plan. Sun Life, which
administers group benefits plans for more than 22,000 Canadian
companies, oversees health and dental coverage for more than five
million Canadians - including dependents.

"We as a society are starting to see an interesting evolution over
time," said Joan Weir, director, health and disability policy at the
Canadian Life and Health Insurance Association. "The number of medical
prescriptions that are being issued is growing at a substantial rate
for medical cannabis and in turn that means a lot of plan members are
now using it … so insurers are also watching this more closely."

Several years ago, life-insurance companies could deny coverage for
clients who were occasional users of marijuana. In 2016, Sun Life was
one of the first insurers to assess people who use marijuana when they
apply for insurance as non-smokers. Now, life insurers are looking to
add medical marijuana to their suite of covered benefits, easing the
costs for users.

"Medical evidence supports the use of cannabis for some serious and
severe medical conditions," Dave Jones, senior vice-president of group
benefits at Sun Life, said in an interview with The Globe and Mail.
"As this has become something our clients - being the individual
companies known as plan sponsors - have been asking us about more and
more, we have moved from the stage of evaluate and review, to now
offering it as a benefit for medicinal purposes."

Individual companies will now be able to request the added coverage
for their employees as well as choose a yearly benefit amount ranging
from $1,500 to $6,000 a person.

The new medical-cannabis coverage will include a prior-approval
process. Plan members or eligible dependents will only be covered if
they meet the clinical criteria, as defined by Sun Life, and have
their cannabis dispensed according to government regulations.

The debate as to whether the use of medical cannabis should be covered
by an employee insurance plan has been a continuing one. Many employee
benefit plans do not cover prescriptions for medical cannabis since it
does not have a drug identification number (DIN) - something that
insurance companies require in order for a drug to be covered and that
are issued by Health Canada.

Several individual cases have emerged in front of the courts in order
to determine an outcome.

In a landmark ruling last spring, Gordon (Wayne) Skinner went in front
of a human-rights board after he said he faced discrimination from his
employer when he was denied coverage three times through his
work-sponsored plan. Mr. Skinner had suffered from chronic pain after
an on-the-job motor-vehicle accident.

The board ruled in Mr. Skinner's favour, stating his employer must
cover his medical-marijuana expenses.

A user of medical marijuana could pay several hundred dollars a month
depending on the size of the prescription. For some patients, a
portion of cost involved with using medical cannabis was being offset
through health-care spending accounts. But not every company offers
these accounts, leaving many without any supplemental coverage for
cannabis prescriptions, said Chris Gory, an insurance adviser with
Insurance Portfolio Financial Services who specializes in group
benefits plans.

"The [added coverage] is a big game changer for many of my clients as
only one in every eight offer health care spending accounts within
their plans," Mr. Gory said. "Now, Sun Life is opening the door for
many Canadians who really need access to this type of coverage. Not
only is this going to help drive down pain for a lot of patients, but
it is also going to help drive down drug costs for companies."

For those companies who choose to add coverage, there is a limit to
what medical conditions will be approved. The coverage will be
available for employees who are using cannabis to treat cancer with
severe or refractory pain; or with nausea or vomiting associated with
cancer treatments, multiple sclerosis with neuropathic pain; or with
spasticity, rheumatoid arthritis with pain that failed to respond to
standard therapy, HIV/AIDS and for patients requiring palliative care.

Sun Life said it will conduct periodic reviews of evolving clinical
evidence, supporting the use of medical cannabis for conditions not
listed. As well, plan sponsors can submit prior-approval requests for
other conditions that Sun Life will examine on an individual basis.

The cost of adding the coverage takes into account a number of
factors, but initially Sun Life does not expect it to rise, Mr. Jones
said. In the beginning not every company will opt to include the
additional plan; as well costs will be kept minimal, for now, as a
result of Sun Life confining coverage to five specific conditions and

For other providers, coverage appears to be done on a case-bycase
basis. Manulife Financial Corp. offers similar coverage on a selective
basis today, but has not offered it as an automatic selection for plan

"Manulife is supportive of clients that want to consider introducing
medical cannabis as an option," a Manulife spokesperson said in an
e-mail. "We also recommend that clients put limits and some management
controls in place as this is an emerging market that is quickly evolving."
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