Remember the little rhyme we recite to toddlers to teach them the names of their body parts…fingers and toes…eyes—ears—mouth—and nose. Now, I think this is in reference to remembering all of the Personal Protective Equipment (PPE) necessary for the day-to-day jobs in health care and beyond. No one is exempt. All jurisdictions in Canada have requirement for workers to use PPE.

Consider your basic practitioner’s office that will now require, some if not all of these additional pieces of disposable equipment for each and every patient visit:

Gowns, gloves, face masks, eye protection, plastic visors, hair covers, seat covers, shoe covers

Add to this the basic additional sanitization, social distancing, and monitoring of the waiting room, the hallway, and the restrooms. These include light switches, door handles, toilets, taps, handrails, countertops, mobile devices, keyboards and so much more. Basically, anywhere where there are people.

Of course, we understand the rationale. We absolutely need to reduce the risk of transmitting of COVID-19 from individuals in the asymptomatic phase.

Then, once all of this is completed, in accordance to official guidelines for operation, the practitioners, staff, and patients are protected, and the business is ready to open. BUT now the time for service has elongated, the number of customers seen in a day is limited, in some cases to half of pre-COVID appointments and staff have been split to adhere to distancing. This reduces revenue when the expenses have increased due to the additional equipment. 

Some reports suggest this cost annually may be as much as $13,000 to a practitioner’s office, or $15-$40 cost per patient visit. 

Who’s going to pay this bill?

The consumer of course.

Ultimately, this is a concern for the benefit plan. Consider this fictionalized health care claim example:

Pre-COVID Post-COVID
$100 expense
$0 PPE $15 PPE
80% coverage
$100 Claim $115 Claim
$80 Reimbursed $80 Reimbursed
$10 out of pocket, after tax expense $25 out of pocket, after tax expense

What happens when the employee submits the receipts to the benefit provider with the expectation that the claim will be paid in accordance to pre-COVID-19 guidelines and that is not the case because the insurers won’t (at this time at least) cover PPE as an eligible expense? Suddenly the value of the “benefit” has been lost, employees are upset, and don’t get me started on the after-tax implications. 

Want to talk about this SHifT and other topical benefit issues, join our weekly 30-minute free #thursdaypivot Zoom Cast, we’d welcome the opportunity to chat.

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