Put Your Oxygen Mask on First: Discussing Health Benefits in a Caring Sector

Originally published here and written by IONS Content Strategist, Lydia Phillip and Engagement Lead, Clary Chambers.

This blog started with?a conversation between Lydia and Clary on a noisy park bench in Halifax. Writing a 2,500 word piece is more difficult for Clary, who is dyslexic. Contribution happens in different ways, voice memos, verbally, Teams chats, etc. and though Lydia’s writing is the medium used – the ideas, energy, and passion are collectively shared. The result was a more accessible collaboration and this blog that we’re incredibly proud of. We hope you enjoy.?

I grew up unfamiliar with how employee benefits and insurance work. My parents worked low or no wage jobs before my dad started his own business – all of which didn’t have health benefits. This meant very infrequent trips to the dentist and eye doctor, going only when necessary. When I entered the work force, benefits weren’t a priority – I knew they cost money I probably couldn’t afford. It’s assumed that how coverage works is known, but I couldn’t make sense of the documents and process, so I never signed up when I landed at an organization that offered health benefits. It wasn’t until nearly three years into that job when a colleague was talking about their self-care routine that I learned our workplace fully covered employee benefits and 100% of submitted costs. As someone who received diagnoses later in life and could have used preventative care and resources earlier – access to health benefits has been a gamechanger.?

Everyone has a different experience and entry point to health benefits – some people have coverage from childhood, some gained access upon entering the workforce, and some have yet to access preventative care due to unaffordability or working jobs that do not provide access to benefits.?

The Problem with Tying Wellness to Work

Our relationship with our health and wellbeing is largely influenced by white supremacy and capitalism. These systems have intentionally generated wealth around whiteness and colonial ways of working, creating the myth of “low-skill” work to justify exploitation, unliveable wages, and to deny supports for a healthy life. Our proximity to “employability” – our capacity for a 9-5, our perceived ability to work, and the assigned value of that work – is a major indicator of whether we can be healthy and well or not. And those from equity-deserving communities, particularly Black and Indigenous people, experience greater rates of poor physical and mental health (Foodbanks Canada, 2023 ). Often, health is positioned as a luxury of the wealthy and powerful.?

Despite having “universal healthcare”, preventative care – the tools we need to be in this world (vision care, dentalcare, mobility aids, all therapy, etc.) –?is an out-of-pocket expense. It’s largely inaccessible if you don’t have a job that is considered “of value.” Traditional “women’s work”, part-time, low wage, and non-traditional work often don’t offer employee benefits. Not only does capitalism inherently tie our labour to our ability to survive (afford food and shelter), but also to how we care for our body, mind, and spirit. ?

In an individualist, capitalist society that quite literally doesn’t care if we can live or not, many of us need to rely on our places of work to fill the gaps related to our overall health – especially in a province where 15% of the population don’t have a family doctor. To build a healthier, more just world, we must use strategies like providing health benefits to people – especially to those who have the least access due to systemic oppression. We all deserve the ability to live healthy lives.?

Considerations for Impact Organizations

With the work we do and who feels called to respond to collective needs, the Community Impact Sector is one in need of constant healing.?Incredibly diverse, the sector employs a higher proportion of women, Black, Indigenous, racialized, queer, and disabled people than any other industry.?We often enter this sector because we see inequity and a chance to make a difference, but our life experiences can also mean that many of us need or rely on?preventative care. In a burnt out, highly gendered, racialized, and underpaid sector – access to holistic care becomes even more important. ?

We know the sector is underfunded and under-resourced and there are admin burdens and associated costs with benefits provision, but it’s a major attraction and retention tool, allowing for happier, more productive staff. There’s a sector-wide group benefits plan that IONS, Community Services Benefits Trust (CSBT), and NewGround Financial offer at more affordable, consistent rate (the plan IONS uses). Also, we just need to care for our people and do better. Below are four considerations for employers around implementing group benefits.

1. BENEFITS AND RECIPROCITY

I empathized with one of my friends who was stuck in a harmful, racist work environment because they were healing from an extensive injury?and relied on the health benefits at their current job. Changing jobs meant losing their benefits and having to go without rehabilitative care during a new employer’s probation period – which wasn’t an option for them. I’m sure we’ve all heard similar stories or have been the one who couldn’t afford to be in jobs that didn’t provide health benefits or who couldn’t accept new opportunities and experience a gap in healthcare due to lengthy probation periods.?

At IONS, health benefits are available starting immediately. This is an update in?our organizational practice. Providing this simple change can make a difference in someone’s life, especially when we consider the justice and equity implications – racialized people are less likely to find jobs that offer benefits; equity-deserving groups experience more barriers to accessing public services; disabled people are disproportionately affected by inflation and healthcare needs, Black people are less likely to have a family doctor, etc.?

To prioritize people and reciprocity, IONS offers extended benefits on day one. This practice can increase opportunities for people to enter the sector and positively impact an organization’s ability to attract diverse talent, retain staff, and keep teams engaged.?

2. A CULTURE OF CARE

Three. That’s the number of sick days the Nova Scotia Labour Standards Code mandates. Unpaid. Our province has some of the least generous employee entitlements in the country. IONS provides 12 paid wellness days annually, carrying over unused days into the next fiscal to a maximum of 24 days per year. These can be used for anything from illness, care for a loved one, menstrual pain, mental health needs, to therapy appointments. If we want to push back on scarcity mindsets and burnout, organizations need to be proactive in creating healthy?spaces and?supporting?preventative care.?This means fostering a culture where we are allowed to be human and people are encouraged to be well, because maintenance of our physical and mental health is just a part of life.

For organizations, this could look like flexibility to book appointments throughout the workday when necessary, normalizing people taking time off, and providing additional paid sick/ wellness days (unsure if you can afford to? Check out this Paid Sick Days Calculator ). It could also mean adding a comprehensive benefits overview to onboarding processes, reminders of what supports are available, and encouraging staff to use them. Organizations that make it easier for us to care for ourselves, better allow us to care for our communities – which sets a good example and models change for others.?

3. ACCESSIBILITY AROUND LANGUAGE & ADMIN

Raise your hand if you’ve put off reading through long PDFs and pages upon pages of insurance jargon! It can be overwhelming trying to navigate new systems and decipher corporate lingo and technical terms to understand what’s provided and covered.?The language and format are so inaccessible – some documents aren’t compatible with screen readers, fonts are too small, the language is confusing, or people simply process differently. Cumbersome processes and barriers can prevent staff from using benefits, even if they have access through their workplace.

Additionally, administration of group plans often fall to staff who are overworked, and perhaps trying to understand the associated tasks and implications themselves. Organizations can support teams by providing training or video walk throughs of the processes. They can create plain language guides on the steps, a glossary of terms, and a high-level coverage overview (ask your insurance provider if they have something similar or that could be modified). ?

4. INCLUSIVITY & CULTURALLY INFORMED CARE

As inclusive as organizations try to be, there are some limitations around third-party providers. Insurance companies are not always queer-inclusive in their language, which can be triggering for many. Often sign-up forms and questionnaires don’t recognize gender diverse individuals or inaccurately use the terms “sex” and “gender”. Or plans and coverages assume heteronormativity, cisgendered couples, and “traditional” family structures. For more inclusive practices, organizations can give feedback to their benefits providers about correct language that?is inclusive of 2SLGBTQIA+ communities, and should provide a content warning/ disclaimer on internal documents so it’s less jarring for folks.

In a diverse sector, we know the importance of culturally-informed care and an anti-oppression lens. Indigenous, Afrocentric, and anti-colonial approaches and non-traditional healing can offer safer, unbiased spaces for community members. However, these services might not be recognized under corporate insurance structures – they may not have direct billing or they may not be covered under your benefits. When seeking out insurance providers, organizations can ask about coverage and options around culturally related care. Providing a health spending account can also help subsidize costs if an employee is looking for care that isn’t covered (IONS provides a $250 wellness fund for staff). Organizations can also start curating a list of culturally-informed practitioners, resources, and provincial or local organizations that offer services or support navigating.?

On Being Human in the Workplace

We know that care and access to care look different for different people. Not all organizations provide benefits or perhaps your coverage isn’t extensive, so we want you to know that your benefits allotment doesn’t define your worth.

Below are some suggestions that we’ve found helpful when navigating preventative care both with and without benefits, along with some ideas of how to get the most out of your coverage and care for yourself.???

• Talk to your employer: “Did you know IONS has a partnership with Community Services Benefits Trust and NewGround Financial that offers sector-wide group benefits plan that make it more affordable and accessible for?small impact organizations in Nova Scotia? You can learn more here .” Feel free to copy and paste that to send to your ED! ?
• Negotiate benefits: If you are negotiating a new job, ask for benefits to start immediately and ask to use work time to access preventative care if this isn’t already a policy. Self-advocacy supports everyone on a team, which?is how IONS updated our practice on benefits provision. ?
• Ask for a sliding scale:?A sliding scale is a reduced rate – often a range of “pay what you can” or a fixed cost that’s more affordable. The costs of some health services and information on different pricing options aren’t always up front. Many health providers do have a sliding scale, but only on request. This is especially common for therapy, but asking any service provider could allow you to stretch your allotted coverage further to access more care. ? ?
• Investigate your options: Different pharmacies have different dispensing fees (when Clary was benefit-less, she learned that COSTCO has lower prescription costs and a membership isn’t required to access the pharmacy). There are also impact organizations that provide a variety of free services and care to community members. Or some community colleges with wellness programs (massage, physiotherapy, etc.) provide very reduced rates for students to gain experience in their practice. And some counselling clinics supervise Master’s students during their practicums and offer lower rates when you work with them.?
• Use your benefits: This may seem a moot point, but many of us don’t make time for ourselves. And if you’re not using your benefits – depending on how they’re administered – you might be paying more out of pocket to contribute than you’re getting benefit from. Carve out time to use services, submit claims, and check usage amounts left for the year.?
• Use your sick days: Actually. Use your sick/ wellness days guilt and shame free! Why do we feel like we need to be in a major crisis to justify time off? How does this contribute to burnout? Let’s normalize using sick days as a type of preventative care.?
• Ask for assistance: It’s easy to put off our own care when we experience barriers.?If you’re having trouble accessing benefits, understanding your coverages,?setting up your accounts, or have questions – please, ask. Ask someone on your team or the insurance providers – they often have a help desk and are typically quick to respond.

We invite you to reframe the way you might be thinking about your wellness needs. You are deserving of preventative health measures and prioritizing yourself even if “nothing is wrong.” What if you scheduled an appointment right now, or submitted a reimbursement claim, or called your benefit provider to learn how the systems works or started the conversation of implementing benefits in your workplace. Sometimes it’s the small steps. Remember that taking time away from front line work to care for yourself is caring for the folks you care for too.?

In Summary

Health benefits are a valuable support to live a good life and can be a crucial aspect for people to accept and stay in jobs. With our Beyond Decent Work campaign, we make the argument for providing health benefits and the ability to attract and retain people in a labour market crisis. But also, the Community Impact Sector employs a greater percentage of women, racialized, disabled, and queer people – and we have a responsibility to support and model just, equitable practices. Despite the conditions that weren’t built for us, Clary and I need you to know that you are worthy of holistic care. You have a right to rest and be well.

ADDITIONAL RESOURCES:

• Program: Sector-wide Group Benefits Plan??
• Infographic: Benefits 101??
• Infographic: Health & Dental Benefits
• Resource: How Do Group Benefits tie into Wellness at work
• Program: Employee and Family Assistance Program?
• Possibility Brief: Increasing Total Compensation in Community Impact Sector ??
• Resource: Paid sick days calculator