Key Conversations in Benefits

As we kick off 2026, we look back at the employee benefits conversations that shaped 2025 in Canada. Based on discussions with employers, carriers, and providers, certain themes stood out — from wellbeing and women’s health to cost pressures, flexibility, and financial wellness.

This article highlights the top trends and insights that dominated the year, showing how benefits continue to evolve toward more holistic, inclusive, and sustainable solutions for both employees and employers.

Weight Management as a Chronic Disease

We ended the year talking about weight-management medications — this was a dominant conversation with clients, advisors, and carriers throughout 2025, and one we expect to continue.

Prescription drugs for weight management were widely discussed by both our supplier partners and clients alike. We fielded questions from plan members asking how to access them and employers seeking guidance on coverage, risk, and long-term sustainability. In Canada, there are numerous approved weight loss medications available including:

• Wegovy (semaglutide)
• Saxenda (liraglutide)
• Mounjaro/ Zepbound (Tirzepatide)
• Contrave (naltrexone/bupropion)
• Xenical (orlistat)

But the conversation went far deeper than medications alone. Providers began addressing weight management head-on, recognizing it as a chronic disease and building supports that go well beyond “eat better and move more.” We saw a shift toward full-scope approaches — integrating clinical programs, nutrition counselling, mental health supports, and long-term behavior management — acknowledging the complexity and prevalence of this condition. With roughly one in three Canadians affected, it’s no longer viewed as only a lifestyle issue, it’s a medical condition that requires ongoing support and benefits designed accordingly.

At the Immix Group, we’ve been helping employers move towards meaningful, evidence-based support that improves outcomes while managing cost pressures.

Addressing Women’s Health through Employee Benefits

Women’s health continued to be a defining benefits conversation in 2025. Survey data this year showed that nearly half of organizations ranked women’s health as a top or high priority in benefits planning, with fertility and reproductive coverage increasingly seen as essential rather than optional.

Employers heard from plan members about gaps in coverage for fertility, reproductive care and mid‑life health, and that traditional plans weren’t keeping pace with real needs. Data from a 2025 RBC Insurance survey showed that three‑quarters of women say they want or need benefits that specifically support women’s health, including fertility and menopause services, highlighting persistent coverage shortfalls employers can no longer ignore.

In response, carriers and employers began evolving plan design and support. Insurers are expanding access to virtual care, reproductive resources, and wellness programs tailored to women’s needs, while employers are looking beyond core coverage to include supports that span family planning, pregnancy, postpartum care and hormonal health.

At the Immix Group, we’ve been encouraging employers to think holistically — integrating creative solutions like health and wellness spending accounts that cover childcare, lactation support, mid‑life therapies and mental health practitioners alongside traditional benefits.

We also highlighted the need for much stronger support for perimenopause and menopause — from hormone therapy and medical consultations to mental‑health support, menopause‑inclusive sick leave, and workplace awareness.

Women make up a large portion of the workforce, and without intentional design, benefit plans risk falling short on equity and effectiveness. By putting women’s health squarely in the center of benefits design, employers can build a more inclusive, supportive, and high‑performing workplace for everyone.

Flexibility, Personalization and Inclusivity in Benefits Plans

Flexibility, personalization, and inclusivity are increasingly a key factor in conversations around employee benefits in Canada. With Millennials (ages 29–44) and Gen Z (under 29) now representing over 50% of the workforce, employees are looking for benefits that feel relevant, adaptable, and reflective of their individual circumstances and life stages.

Employee benefits plans need to support a wide range of needs — from single young professionals, parents and caregivers, to LGBTQ+ employees and even retirees. While traditional group insurance remains the foundation for many employers, the focus is increasingly on ways to introduce meaningful choice and customization.

Modular or “flex” insurance plans are often discussed, and some products are available in the Canadian market such as the Equitable Life myFlex plan. However, these plans are less common for small and mid-sized employers because they can be costly to implement and complex to administer. Many providers will not offer true flex/ modular plans for groups under certain size thresholds, often 50–100 lives or more.

In the SMB space, flexibility is more commonly achieved through the inclusion of a Health and Wellness Spending Account to supplement the insured program. Health and Wellness Spending Accounts allow employees to use a predetermined annual allocation for the services and supports most important to them, whether that’s fitness, mental health, chronic condition management, or family care. This approach helps direct benefits dollars where they are most needed, increases perceived value, and improves employee satisfaction.

For Millennials and Gen Z especially, the desire for meaningful benefits is underscored by a desire for robust digital platforms that allow for intuitive, mobile device claiming and engagement. For employers, the challenge remains delivering comprehensive and inclusive benefits while keeping them cost-effective, sustainable, and manageable — a balance that is increasingly achievable as flexibility and personalization become central to benefits strategy.

Balancing Cost Pressures with Coverage Needs

Cost pressures were a frequent and defining theme in benefits conversations throughout 2025, particularly for small and mid-sized businesses. With inflation, wage pressures and rising operating costs continuing to strain budgets, SMB employers became more price sensitive than we’ve seen in recent memory.

Across the industry, we saw increased plan movement driven primarily by pricing — not by service failures or coverage gaps. Employers placed greater emphasis on rate stability, predictability and overall value, prompting more frequent plan reviews, marketing of plans, and discussions around alternative carriers and funding approaches. Through these processes, the Immix Group worked closely with employers to identify opportunities to maintain meaningful coverage while managing costs, including implementing thoughtful plan amendments where appropriate.

Our approach remains consistent: a focus on long-term value, cost sustainability, and thoughtful plan design — not short-term price chasing. Our broker-managed pools remain a solid strategy for small and mid-sized employers, offering plan flexibility, cost control, and lower administrative overhead.

Rather than responding to cost pressure by simply reducing coverage, we worked with employers to refine plans strategically: preserving high-value benefits, adjusting underutilized features, and layering in flexible tools such as Health and Wellness Spending Accounts where appropriate. A  year defined by economic uncertainty and added cost pressure reinforced a principle we’ve long held: well-managed, thoughtful benefit structures — paired with proactive oversight — remain the most effective way for SMBs to balance affordability, stability, and employee wellbeing.