Disability Insurance

by Lindsay Byrka, BA, BEd, CFP®


Dig Deeper into Disability Insurance

Trying to wrap your head around Long-Term Disability insurance? Wondering about the differences between your group Long Term Disability and an Individual Disability plan?

Group benefits plan administrators, have you done your part to ensure your employees understand their coverage and the monthly amount they would receive in the event of a disability?

As benefits advisors in Vancouver, BC, we strongly believe in the need for thoughtful, quality disability insurance products. The focus of this article is to provide deeper insight into the importance of disability insurance, the basics of group Long Term Disability, and how an individual policy may come into place.

Key Takeaways:
  • 1 in 6 people will experience a disability before age 65.
  • Mental health is the largest category of claims, at 31%.
  • Just under 50% of people have group Long Term Disability plans through an employee benefits program. Of those without workplace coverage, only around 15% have individual plans.
  • Even with a group Long Term Disability plan in place, many do not have adequate coverage (amount or quality can be lacking).
  • It’s essential to know how much coverage you have and to understand how your plan works.
  • Employers must be diligent in ensuring employees understand their coverage level and plan parameters.
  • Employers can help bridge shortfalls in coverage by organizing for underinsured employees to place top-up disability policies.
  • Group Long Term Disability is typically provided through an employer and has set coverage limits and parameters, while individual disability insurance is personally obtained, customizable, portable, and not tied to employment.

It’s more common to experience a Long-Term Disability than most people realize


Everyone knows someone that’s been diagnosed with a serious illness, or experienced a significant injury – unfortunately, it’s all too common. This almost always means a significant amount of time off work, or in the most serious situations, the inability to work again due to a permanent disability.

While many people consider the medical and lifestyle implications, people often fail to think through the financial impacts of no longer being able to work. There is an expression in the insurance industry- “Your health is your wealth” – and this couldn’t be more true! For most people, being healthy directly ties into their ability to provide for themselves and their families.


Disability insurance is income replacement insurance

Most people are familiar with disability insurance, but they may not think of it for what it really is, which is “income replacement insurance.” But how much do you need? When people are asked “What percentage of your income would you need if you were no longer able to work?” many people state: “All of it.” The fact is, becoming sick or injured usually means more expenses, not fewer. Having your income reduced or eliminated for a period of time can completely derail your ability to stay on track with goals for yourself, your family, and your business.  

The statistics are surprising: 1 in 3 Canadians will become disabled and unable to work before the age of 65 (RBC Insurance).

disability insurance

Source: RBC Insurance. “Sales Resource Centre.” RBC Insurance, June 2024, www.rbcinsurance.com/salesresourcecentre/file-777224.pdf. Accessed 28 June 2024.

A common misperception surrounding disability insurance

Many people believe that all medical costs relating to serious life-impacting illness and injury are insured either through provincial health care or your employer-sponsored extended medical plan.

Unfortunately, this is rarely true. Many expenses arise in connection with disability, including:

  • Uninsured medical expenses for equipment, drugs, and practitioners (physiotherapy, orthopedic braces etc)
  • Time off work for the other spouse to be a caregiver
  • Modifications to your home (ramp, grab rails, renovations to relocate bedrooms, etc.)
  • Assistance with childcare, cleaning, cooking or other daily activities

Disability insurance provides you with a continuing income while you are unable to work.


Far too many people are not insured or are under-insured

Just under 50% of people have group Long Term Disability plans through an employee benefits program. Of those without workplace coverage, only around 15% have individual plans.

Unfortunately, many people are completely uninsured in this area. This means if something were to happen, they would be reliant on just EI Sickness benefits through Service Canada. The 2024 maximum payment is 55% of your weekly earnings, to a max of $668 a week (taxable) for a maximum of 26 weeks duration. There is some coverage through the Canada Pension Plan, but again, it’s difficult to qualify and benefits are minimal.

For most people, this is totally inadequate. The bottom line, relying on government coverage is not ideal.


Why don’t all employers offer group Long Term Disability?

While we encourage employers to implement group long term disability coverage, stats show under half of workplace plans include this crucial coverage line!

A few common reasons are:

  • Cost of coverage: Long Term Disability premiums should be employee-paid to create a tax-free benefit in the event of a claim; it can be difficult to get employees on board with paying a portion of the benefits premiums, especially if the plan has traditionally been an employer-paid benefit. Unfortunately, employees often misunderstand the importance of this coverage line and simply do not want to pay the premium.
  • Uninsurable industries: Some industries are difficult or impossible to insure due to the risk of claim; different insurers have different requirements, but all have industry lists of occupations they will not insure.
  • Size of the group: Some insurance providers will not implement group Long Term Disability for groups under a certain headcount, although there has been increasing flexibility in this area. For many small employers, they feel they cannot afford to offer more than a basic health and dental plan, or they do not feel the need to offer comprehensive coverage.
  • Misperceptions: Many employers and employees fail to understand the importance of this coverage and may have incorrect assumptions regarding government programs.

From our perspective at the Immix Group, education in this area is key! While we don’t think twice about insuring our valuable physical possessions (our house, car, boat, jewellery), and most people understand the need for life insurance, disability coverage is too often overlooked.


A typical group Long Term Disability plan provides good coverage for most people

Firstly, let’s address group Long Term Disability coverage; it’s our belief that this should be included in all employee benefits programs. A typical group long term disability plan is set up as follows:

  • 67% of monthly earnings to a maximum benefit amount (for example, $5,000 per month);
  • A Non-Evidence Maximum (NEM) applies, which is the amount of coverage you can get without providing evidence of good health (for example, $3,000);
  • Coverage (and potentially benefit payments) continue to age 65;
  • A two-year ‘own occupation ‘period usually applies.

These limits are based on the group: average income, occupation, and overall size. Generally speaking, the larger the group and the higher the average income, the higher the NEM and Max Benefit.

Many people find themselves under-insured through a group Long Term Disability plan

For a percentage of groups (this varies greatly depending on the group) the higher earners find themselves underinsured through a group plan. While advisors can request for increases to the group limits, there are often outliers who simply cannot be adequately insured due to the limits the insurer imposes. Consider the following simplified example:

  • Annual Income: $200,000 ($16,667 monthly gross, ~$10,000 net)
  • Group Long Term Disability: $5,000 per month max
  • Income Replacement Percentage: 50% ($5,000/$10,000)
  • Shortfall: ~$5,000 per month

In the example above, the individual insured may have no idea they would be receiving only around half their pre-disability income; many people simply do not pay attention to the specific details of their coverage.

The most common types of claims? This may surprise you, but Mental Health claims are the largest category of disability claims.

Types of disability claims

Source: RBC Insurance. “Sales Resource Centre.” RBC Insurance, June 2024, www.rbcinsurance.com/salesresourcecentre/file-777224.pdf. Accessed 28 June 2024.

We strive to ensure HR personnel and other leadership are aware of potential shortfalls

At the Immix Group, we review the list of those with a disability shortfall at every program renewal; it’s important that those with shortfalls are aware they are not fully insured. It is the role of the plan administrator to ensure this information is clearly passed along to affected plan members. Individuals may be able to apply for amounts above their Non-Evidence Maximum, or they may wish to pursue a top-up disability plan. But the first step is ensuring the details are made clear to the member.

Bridging the gap with Individual Disability top-up plans

Many people seek out individual disability policies, and in fact, we assist with this every day.

For those with a shortfall in coverage, it’s important that plan administrators ensure they are presented with their options and assisted through the process by a qualified advisor.

Whether you are seeking an Individual Disability policy because you do not have access to a group plan, or you are seeking to “top-up” the coverage on your group Long Term Disability plan, the process is similar.

In contrast to a group disability plan, individual policies are usually fully underwritten which means a medical and financial assessment is made by the insurer. An exception is with Guaranteed Standard Issue group disability policies, which in short, is a group of individual policies issued to a group of qualifying employees, with limited underwriting.

What about Short Term Disability coverage?

A small percentage of companies provide insured Short Term Disability coverage, and some companies provide some form of in-house continuing income. However, this is not required and the majority of employers default to Government Employment Insurance Sickness Benefits for the duration of time prior to Long Term Disability benefits beginning.

Key differences with Individual Disability policies compared to group Long Term Disability plans

Beyond increasing the amount of coverage to ensure you are fully covered, there are many features available within individual policies that are superior to most standard group long term disability:

  • Portability; The contract is not connected to your employment, you take it with you wherever your career takes you.
  • Individually underwritten; this means the contract is customizable, to an extent. For example, a situation that would result in a “decline” of coverage over the non-evidence maximum under a group plan might be listed as an exclusion under an individual plan.
  • Key riders: individual contracts often allow for popular and beneficial riders to be included:
  • Future Income Option: this allows for your coverage to be increased as your income rises, without medical underwriting.
  • Cost of Living Adjustment: this ensures your benefits during a claim are increased to keep pace with inflation.
  • Controlled cost: Pricing is locked in for the duration of your contract, which is typically to age 65.
  • Own Occupation to age 65: This means you are covered for your “own occupation” to age 65, and not for the typical 2-year duration (details below).

While in some circumstances these features can be included under group Long Term Disability plans, they are not common and are more costly to include.


The “definition of disability” is the most important feature of your plan

A certain “definition of disability” applies- in short, this is how the insurer will define what is considered “disabled”, and under what exact circumstances the contract will pay out to the sick or injured claimant. Very broadly (please note insurers differ):

  • “Own Occupation” refers to being unable to perform all or the majority of the duties of your occupation
  • “Any Occupation” refers to being unable to work in any capacity or at any job.

Under a typical group plan, the first two years of disability cover the insured person for their “own occupation.” After two years, the person is considered disabled based on meeting the definition of disability for “any occupation,” a more restrictive definition.

In contrast, many individual plans cover the insured person on an “own occupation” basis to age 65. This varies between plans, and availability varies based on the insured’s unique characteristics and occupational duties.

The wording used in the contract is crucial and differs between insurers; our role is to understand this and ensure that coverage is appropriate based on the unique needs of the group or individual.


Long Term Disability coverage is essential and needs to be understood

For the majority of people, the coverage through a group benefits program will provide them with income replacement to the allowable limits (you cannot be insured for greater than your pre-disability income), meaning they are adequately insured, with regards to the dollar amount of coverage in place.

But, as we have alluded to, the quality of the coverage requires a deeper dive, and one size does not fit all.


What should employee benefits plan administrators and HR personnel do?

Know the numbers– do shortfalls exist for your team? If so, to what extent? Can this be addressed adequately through the group insurer? Have you clearly communicated to each plan member the details of their group Long Term Disability coverage and ensure they understand how to apply up to the maximums available, whether this is through the Group Long Term Disability or through a top-up policy?


The Immix Group is here to help

Part of our role as Canadian benefits advisors involves analyzing and making recommendations on the appropriate Long Term Disability program for your company, and by extension, ensuring full coverage options are made available for the individuals within your organization. The Immix Group works with businesses and individuals across Canada and across all sectors. If you would like to ensure you or your team members are adequately covered, we invite you to reach out and engage with one of our qualified advisors to discuss your options. – we love to hear from you!

Contact Us: Immixgroup.ca or call us at (604) 688-5559.  

Read More

The Power of Protection: Understanding the need for Living Benefits Insurance

– The importance of living benefits insurance: protect your financial stability in the face of illness or injury

Fewer Canadians have disability coverage through workplace benefits, leaving them more at risk

– Despite the risks, a significant number of Canadians lack disability coverage, facing financial vulnerability in case of disability

Disability: A Canadian Reality

– It’s more common than you think. Protect your most valuable asset – your ability to earn income.

Disabled Workers Face a Perfect Storm

– Canadians off work due to disability face a perfect storm.


Top 7 FAQs

Group LTD insurance is provided by employers and has set coverage limits and parameters. Individual disability insurance is personally obtained, customizable, portable, and not tied to employment.

Understanding your coverage is crucial because many people are under-insured and unaware of the shortfalls in their plan. This knowledge ensures you can address any gaps and be adequately protected financially in the event of a disability. 

LTD insurance provides income replacement when you are unable to work due to a disability. Group plans typically cover 66.67% of monthly earnings up to a specified maximum, continuing until age 65, with a two-year ‘own occupation’ period followed by ‘any occupation’ criteria.

Common reasons include the cost of coverage, difficulty insuring certain industries, the size of the group, and misconceptions about the necessity and importance of LTD insurance.

Yes, you can have both. Individual policies can act as a top-up to ensure you have sufficient coverage beyond what is provided by your group plan.

Individual policies offer portability, customizable coverage, key riders like Future Income Option and Cost of Living Adjustment, controlled costs with locked-in pricing, and often an ‘own occupation’ definition until age 65.

Employers should clearly communicate the details of the group LTD coverage, identify any shortfalls, assist employees in applying for maximum coverage, and offer guidance on obtaining top-up policies if needed.

About Us:

Immix Group Employee Benefits Ltd., headquartered in Vancouver, British Columbia, is an independent employee benefits consulting firm with a history spanning over 30 years. Our client-centric approach has led to successful partnerships with over 400 employers across various sectors and regions.

With longstanding supplier relationships spanning decades, we collaborate closely with insurance and investment providers, fostering a culture of mutual respect. Our role is to partner with our clients in the design, implementation, and ongoing management of benefits programs. Our consistent engagement with HR personnel, financial and operational staff, and plan members guarantees exceptional service, comprehensive coverage, and sustainable costs.

Have any questions? Contact us at: info@immixgroup.ca or call us at (604) 688-5559 – we love to hear from you!


The Immix Group is an Employee Benefits firm based out in Vancouver, B.C. The information provided in this article is for general informational purposes only and is not intended as legal, financial, or professional advice. While we strive to ensure the accuracy and reliability of the information presented, we make no warranties or representations of any kind regarding its completeness, accuracy, or suitability for any particular purpose. Readers are encouraged to seek independent advice from qualified professionals regarding their specific circumstances. The authors and publishers of this article are not liable for any losses or damages arising from the use or reliance on the information provided.

Lindsay Byrka

Lindsay Byrka BA, BEd, CFP

Vice President, Immix Group: An Employee Benefits Company
A Suite 450 – 888 Dunsmuir St. Vancouver V6C 3K4
O 604-688-5262 E lindsay@immixgroup.ca
W www.immixgroup.ca

Mental Health Support: A Simple Guide to Providing Mental Health Coverage within your Employee Benefits Program

How employers can support employee well-being within an employee benefits program

As defined by the Canadian government: mental health refers to one’s general state of psychological and emotional well-being. We acknowledge this is a complex and nuanced topic, and that an employer’s role in supporting positive well-being extends far beyond the insurance coverage they offer to employees. However, our focus here is on employee benefit products and services that fall under the ‘mental health’ umbrella.

We are often asked “what more can we do” when it comes to mental health coverage. We have outlined the key areas of coverage for mental health and addressed how they should be reviewed, potentially amended or enhanced, and additional layers or adjacent programs you may wish to consider.


Supporting Mental Health: Crisis Response vs Ongoing Care and Support

One thing to consider is an emergency or crisis situation versus an ongoing situation an employee may be struggling with. One may lead to another. While there are many quality resources available for those reaching out during a crisis (there are a plethora of hotlines available to members of various communities, for a wide range of issues or just general support), when an issue requires ongoing professional support, a financial barrier to care may present itself. In this article, we have outlined the various layers of support.


Employee & Family Assistance Program; the First Level of Support

Employee & Family Assistance Programs or EFAPs (also called Employee Assistance Programs or EAPs) are well-known for their ability to provide 24-7 phone-based, online or direct support to members experiencing any sort of life event for which they need assistance. As we’ve written about, they offer benefits to both employers and employees. Most EFAP providers have extensive online resources available on a large variety of topics, and these often do not require membership or a login.

Most plans offer some level of face-to-face or virtual counseling. While this varies depending on the EFAP, they are typically best suited to issues that can be resolved in the shorter-term, or where the member would benefit from referral to relevant online or community resources. 

Our experience is that most members who require ongoing support desire to continue with face-to-face or virtual sessions directly with a counsellor of their choosing, who specializes in their area of concern. A downfall of EFAPs can be the inability to continue sessions with the same practitioner, once the limited free sessions expire. In this situation, a member may look to claim under their extended health care program.  


Paramedical Practitioners; Reimbursement for Therapist Visits

Paramedical practitioners are a key component of an extended healthcare offering, and depending on the group, may make up a large percentage of overall extended healthcare claims.

While we still see Massage, Physiotherapy and Chiropractor as the top claimed practitioners, those that fall under the ‘mental health’ umbrella have risen in ranking over the past several years. These practitioners include:

  • Certified Clinical Counsellor
  • Registered Clinical Counsellor
  • Registered Professional Counsellor
  • Mental Health Therapist
  • Psychiatrist
  • Psychologist
  • Psychoanalyst
  • Psychotherapist
  • Psychoeducator
  • Social Worker
  • Marriage and Family Therapist


This list is not inclusive of many other related practitioners that some carriers are willing to include. If you’re unfamiliar with your offering, we recommend reviewing the booklet or contract to determine which practitioners are included; you may want to expand this offering to allow members a greater breadth of choice.


How much paramedical coverage should we provide?

As you may be aware, counselling sessions are extremely expensive, usually well over $100 per visit, depending on the practitioner, type of therapy and region.

A typical plan has $500 of coverage, per practitioner, per person, per year. But keep in mind the providers listed above are usually combined under the dollar limit for “mental health practitioners.”

We often see $750 of coverage these days, and some plans still have lower amounts such as $300. If you do the math, a standard paramedical schedule does not offer many visits to a private therapist.

In an effort to expand the coverage for these categories of practitioners, in recent years we have implemented a higher combined limit (i.e. $1,000 of coverage for these practitioners, while the remainder of practitioners are kept at a lower dollar limit per person per year).

Alternatively, we have provided a specific number of visits, rather than a dollar limit (i.e. 12 visits for mental health practitioners). This is considered a more costly option due to the average per-visit cost.


Health Spending Account dedicated to Mental Health support  

For those facing ongoing expenses, for example, routine visits to a therapist, EFAP and paramedical coverage can run out very quickly. To provide an additional layer of support, a Health Spending Account can be used to provide much-needed dollars to employees.

In fact, while barriers to ongoing care due to stigma or lack of resources may have been removed, financial constraints could be the last remaining reason an employee may discontinue therapy, or not seek professional assistance at all.

As you may be aware, Health Spending Accounts can be fully customized these days to include and exclude items, depending on the Employer’s choice. A Health Spending Account can be used to cover mental health-related expenses; however, the employer may choose to define this.

Coinsurance can also be applied (i.e. 60% coverage) with a Health Spending Account, which is an effective tool in directing employees first to their EFAP (potentially), then paramedical coverage under their insured program, and then to their HSA.


Long Term Disability Coverage for mental health claims

Unfortunately, many people find themselves unable to complete the duties of their occupation due to mental health issues. Rest assured, so long as the ‘definition of disability’ within the contract is met, a claim related to mental health can be approved and benefits paid. In fact, a large percentage of claims today are mental health-related, with a larger percentage defined as mental health adjacent. 

Members can receive an ongoing monthly income (a disability benefit payment) so long as they continue to meet the definition of disabled. It is important that employers understand this and communicate this to members who may need to explore a long-term disability claim.  


Financial well-being and mental well-being are connected

While we consider this adjacent to the more direct mental health support and benefits detailed above, a groups savings program can play a role in supporting wellbeing. As we have written about, personal finances are their number one source of stress, according to employee surveys.

Implementing an employer-sponsored group savings program provides twofold support: employer funds via an employer contribution to the savings plan, and additionally, education and tools to assist employees in creating a plan and getting control over their finances.


Steps for Employers:

  • Ensure an Employee & Family Assistance Program is in place; these are often included within your extended health care plan.
  • Review the paramedical offering and ensure appropriate practitioners are included and that coverage levels are as high as affordable to your company.
  • Consider a Health Spending Account to provide additional dollars, as well as flexibility and choice
  • Ensure employees understand the coverage and how to access support and map out how each layer of coverage works.
  • Curate a list (with the help of your advisor!) of good online resources with brief summaries of the support they provide. A simple handout dedicated to this topic, with websites and phone numbers clearly listed, can go a long way.
  • Lastly, include details on all of the above as part of onboarding, but also routinely communicate and update your mental health support program.


By offering resources like Employee & Family Assistance Programs, coverage for various mental health practitioners, Health Spending Accounts, and long-term disability coverage, employers can provide additional support for their employees’ mental health and overall well-being.

At the Immix Group, we emphasize the importance of regularly reviewing and communicating the specific benefits offered to employees through their employee benefits program. This ensures they know how to access and utilize these benefits both efficiently and effectively. For any questions about your employee benefits program and whether you can do more to support your employee’s mental well-being, visit us at immixgroup.ca or call us at (604) 688-5559. We love to hear from you!

There are a plethora of free resources and guides available online. Here are a few:

Top 8 FAQ’s

Mental health refers to one’s general state of psychological and emotional well-being. When employers actively support mental health, they show they care about their employees’ overall well-being, which can lead to a happier, more productive workplace with less absenteeism and stronger company morale.

An EFAP, also known as an Employee Assistance Program (EAP), provides 24/7 phone-based, online, or direct support to employees experiencing life challenges. It offers short-term counseling, referrals to specialized resources, and extensive online materials on various topics, helping employees manage their mental health effectively.

Paramedical practitioners, such as psychologists, psychiatrists, and social workers, provide specialized mental health care. Coverage for these practitioners is a key component of extended healthcare plans. Ensuring a broad range of covered practitioners allows employees to choose the best support for their needs. 

Typical plans offer around $500 per practitioner per person per year, but this can vary. Increasing coverage to $750 or more, or offering a specific number of visits (e.g., 12 visits), can provide better support for employees needing ongoing mental health care. 

An HSA allows employers to allocate additional funds for employees’ health-related expenses, including mental health services. It can cover costs not fully covered by standard benefits, helping employees to better afford ongoing therapy and other mental health support. 

Long-term disability coverage provides financial support to employees unable to work due to mental health issues. If the ‘definition of disability’ in the contract is met and the claim is approved, employees can receive ongoing monthly income, ensuring financial stability during recovery. 

Financial stress is a major contributor to poor mental health. Employer-sponsored group savings programs, which include education and tools for financial planning, can alleviate financial stress and support overall well-being.

Employers should ensure EFAPs are in place, review and enhance paramedical coverage, consider implementing HSAs, communicate coverage details clearly, provide accessible resources, and regularly update and promote the mental health support available.

Read more:

Lindsay Byrka

Lindsay Byrka BA, BEd, CFP

Vice President, Immix Group: An Employee Benefits Company
A Suite 450 – 888 Dunsmuir St. Vancouver V6C 3K4
O 604-688-5262 E lindsay@immixgroup.ca
W www.immixgroup.ca

Claim Confusion

Claim Confusion: Common Reasons Why Your Benefits Claim May Leave You "Out-of-Pocket"

Uncovering why you may be left ‘out-of-pocket’ when claiming under your benefits program

Wondering why you’re left ‘out-of-pocket’ despite having a robust benefits program? There is nothing more frustrating than submitting your claim, only to find it’s not covered, or not covered up to the level you expected.

Here are some common scenarios that explain why your reimbursement might fall short of your expectations.

Is it just the plan design?

Of course, benefits programs differ significantly from employer to employer. Often, the reason for a decline is simply the plan design selected by your employer. While a previous employer may have included certain items, your current employer may have opted to exclude the item.

Largely speaking, while insurance companies have varying default plan provisions, most can customize coverage to meet the employer’s preferences. For example, there is a broad range of paramedical practitioners that can be included, beyond the standard practitioners that most people expect to see. Less common practitioners such as Dieticians, Athletic Therapists, Kinesiologists, and Clinical Counsellors can often be included, but may not be standard for the provider.

While the blame is typically placed on the insurance carrier, more often than not, a decline has nothing to do with the carrier’s ability to cover something, but rather to do with the plan design implemented by the employer, based on a range of factors such as benchmarking information, budget, employee feedback, coverage availability for the industry etc. That said, there are many common rules and plan parameters, as outlined below, that are often the reason for a decline.

Is it the timing?

Many items have frequency limits attached to them, or a certain duration of time that must pass before you can claim the item again.

Understanding how the limits are applied is especially important. For example, does the benefit period apply to the calendar year (i.e. 2 calendar years apart), or at the 24-month mark from when the service was last claimed?

Routine Dental Visits  

The most commonly known frequency limitation is the ‘6-month recall’ often attached to routine dental visits. In short, this means that a routine exam and cleaning will only be covered every six months. If you book an exam too soon, your coverage will likely be declined. To clarify, if it is determined during a routine visit that you require follow-up procedures such as a filling, this does not mean you need to wait 6 months for the filling. It is only the routine exam that falls under the 6-month recall frequency limitation.

Some programs use a 9-month recall in order to help reduce costs. If this is not communicated, you may find yourself un-insured if your recall exam takes place too soon.

Vision Care Cycles

Vision care is commonly run on a 2-year or 24-month cycle, and the distinction is important. For example, your plan might provide vision care coverage defined as one of the following:

  • $200 per 24 months- this means you cannot make a second claim until 24 months from the date of the first claim.
  • $200 per 2 years- this means you could claim in 2022 and then again in 2024, even if your claims were as little as 13 months apart, so long as they fall two calendar years apart.

Frequency limits apply to many other common items including procedures for teeth, hearing aids, medical equipment, and medical supplies. Understanding and carefully reading the wording is important.

Does your coverage reset for the calendar year, or for the benefits year? 

While it’s becoming less common, some programs have their benefits reset to match the ‘benefits year’, which is often the anniversary date of the program, or the renewal date (and yes, these can be different!). This could be at any month of the year. This is in contrast to the benefits resetting for the calendar year, which is the more common plan structure.

For example, a plan may indicate a Benefits Year of May 1st– April 30th. If the program offers $500 per practitioner per benefits year, this means you will have the full amount available to you every May 1st.

The norm, and our preference, is to have benefits reset for the calendar year. This is easier for everyone to understand and aligns with the tax year.

Reasonable and customary limits

If you haven’t heard this phrase before, it’s simply the dollar amount of reimbursement that the insurance company will provide, for a particular item. These amounts adjust periodically, and they differ based on location and insurance carrier.

So, in contrast to naming a dollar value in the benefits booklet, it would indicate that the R&C limit applies:

  • Eye Exams once per year to $100 vs.
  • Eye Exams once per year to R&C limit

Often, the R&C limit is higher than a defined dollar limit. When a program has not been updated in a long time, the defined dollar limit can become very outdated and not representative of the average cost of the service in the area. The choice the employer makes in this regard has an impact; implementing fixed dollar amounts can assist in containing claim costs. 

Charging above the dental fee guides

Here’s the scenario: you have 100% basic dental insurance. You go for a regular cleaning, and nothing unusual occurs. When the dental office submits your claim to your insurance provider, you owe a portion of the total. Why would this be? Why is 100% not actually 100%?

In short, most insurance carriers reimburse based on the current dental fee guide in your province of residence. Dental offices, however, can charge beyond these guidelines. 

Did you know?

You can address out-of-pocket expenses effectively with a Health Spending Account (HSA). Many individuals wonder if HSAs can be used to cover uninsured expenses or supplement coverage for partially covered or capped items and the answer is yes!

Learn how a Health Spending Account can enhance your benefits program and provide additional financial support where needed.

In higher-cost areas, this is particularly common (downtown Vancouver or Toronto, for example). So, when the insurer reimburses at 100%, the fine print is that they reimburse 100% of the applicable provincial fee guide.

In some instances, a plan will provide a percentage in excess of the fee guide or will allow for excess reimbursement for specialists (i.e. Endodontist, Periodontist). Again, this differs from carrier to carrier.  

Dental fee guides adjust each year. As we have written about and discussed with our clients extensively, 2022 and 2023 saw much higher than usual increases, whereas 2024 saw a return to more moderate adjustments.


Claiming under two plans

Remember earlier when we discussed R&C limits? Well, this comes into play when you are claiming under two plans.

If you are covered under two plans, you claim through your own employer-sponsored plan first, then claim second under your spouse’s plan for any unpaid balance. Many people assume that the result should be $0 left out-of-pocket. However, this is not always the case.

Consider this scenario: You go for a physiotherapy visit, the charge is $160, and you claim under your employer’s plan. In your province with your provider, the Reasonable & Customary limit is $120, which is paid out. This leaves you $40 out-of-pocket.

You then claim the $40 to your spouse’s plan, which covers $0 of the remainder. But why? The reason is that the second provider has an R&C limit that is equal to or lower than your own plan’s limit. The plans have coordinated to the R&C limit.

Unfortunately, having two plans does not always mean you will be reimbursed for a higher dollar amount than under one plan.

Please note: R&C limits can differ quite significantly between carriers and by location; for example, with Manulife Financial, the R&C for physiotherapy ranges from $80 (PEI) to $165 (NWT and Nvt) for a regular visit.


Outdated, but standard, coverage limits

Within a program, there are certain extended health care items that have a defined dollar limit of reimbursement, in contrast to others, which do not (i.e. the full cost is covered, at the coinsurance of the program).

These defined dollar limits tend to be quite similar, carrier to carrier. Unfortunately, reimbursement falls short of the actual cost of an item, simply because the industry standard has not kept pace with the actual retail cost of the item. Two examples are:

  • Eyeglasses (especially progressive lenses); while Vision Care amounts can be customized by the Employer, it’s quite common to see $200 per 24 months, which is below the typical cost for certain glasses.
  • Hearing Aids; notably, hearing aid coverage is often at $500 per 5 years, which is far below the typical retail cost for hearing aids which can be thousands of dollars.

In these instances, the employer can request for these plan provisions to be increased beyond the standard insurer provisions. However, these increased coverage limits typically come with a cost.


Errors happen, by providers and members

Quite simply, people make mistakes. Most of the time, when we dig into a denied claim, we learn that the provider or member has made an error when entering the claim. A common issue is claiming for the wrong practitioner (i.e. Acupressure instead of Acupuncture), claiming for the wrong duration of the visit (i.e. a physio receipt says subsequent visit and the member claims for initial visit), or simply keying in the wrong numbers from the member ID card.

In one instance, a claim was repeatedly denied, and we learned the child had been entered by the pharmacist as ‘male’ rather than ‘female’ and the system was therefore not aligning the enrolled dependent to the claimant. A simple error, but frustrating nonetheless for the member standing at the pharmacy watching the claim get repeatedly denied!

Periodically, we come across a denied claim for a very uncommon item (often, a medication). In many instances, the item is simply not coded into the insurer’s system, and with a special request, we can often have the item included.


Understanding the details, matters

As we have outlined, there are many reasons why your extended health or dental claim may be unexpectedly denied or cut back.

We know that the number one indicator of employee satisfaction with a benefits plan is smooth and understandable claims reimbursement. Denied claims are frustrating and at the Immix Group, we want our clients to reach out to us when they encounter issues with their claims.

Even better, proactively, our goal with our clients is to ensure they understand the structure of their plan, and the various rules and procedures surrounding claims.

Employee education sessions where members can delve into the details of their program and ask questions are very useful and can prevent unneeded frustration for members.

At the Immix Group, we are here to help you make the most of your benefits program and ensure a smooth claims experience.

If you encounter issues with claims or need assistance understanding your coverage, don’t hesitate to reach out at info@immixgroup.ca or (604) 688-5559 – we love to hear from you! 

Key Takeaways

  • Many benefits claims are denied because of the plan design implemented by the employer- they may have chosen not to cover certain items or have implemented specific timelines for cost-saving purposes. It’s important to be aware of these limitations to avoid unexpected out-of-pocket expenses.
  • If in doubt, always ensure you obtain pre-approval for any benefits services or items before proceeding with treatment. Pre-approval helps prevent claim denials and ensures you understand what is covered under your plan.
  • Familiarize yourself with any timing limitations in place for your plan. For example, some services may have frequency limitations or waiting periods between claims. If you’re unsure about any details, reach out to your benefits provider for clarification.
  • Understand the Reasonable & Customary (R&C) limits for services covered under your plan. These limits determine the maximum amount your insurer will reimburse for specific services and usually differ by region.
  • Check with your dentist to understand how they bill for services. Some dentists may charge in excess of fee guides, which could impact your out-of-pocket costs depending on your benefits coverage.
  • Navigating benefits claims can be complex, but understanding the ins and outs of your benefits program is essential for maximizing coverage and minimizing out-of-pocket expenses. Take proactive steps to educate yourself about your benefits plan—review your plan documents, ask questions, and seek clarification from your benefits provider or advisor.


Longer durations, such as a 9-month dental recall, are often implemented as a cost containment strategy to reduce claims expenditures within a 12-month period, thereby helping to manage overall program costs.

You or your healthcare practitioner can submit a request for pre-approval. This process is common for dental procedures and other more costly healthcare services, ensuring clarity on coverage and reimbursement amounts before proceeding with treatment.

Not necessarily. While flexibility in coverage can increase with larger employers, insurers must work within provincial health coverage guidelines and adhere to CRA rules/Canadian tax laws. Underwriters may also limit plan designs to avoid excessive claims that could jeopardize the financial stability of the program.

For instance, a smaller group might not have the capacity to offer non-standard coverage like 80% coverage for Major Dental services with an unlimited annual limit. The financial risk associated with such extensive coverage could be prohibitive, especially considering that non-refund insured plans can be terminated without any deficit obligations.

Refer to your benefits booklet or contact your benefits administrator for a detailed list of covered services and items. As well, details are generally available online or through your providers mobile app. Understanding your plan’s coverage terms will help you make informed decisions about healthcare expenses.

Pre-existing condition limitations may apply to certain health conditions that existed before your benefits coverage started. These limitations can impact coverage eligibility for related treatments or services; this is more typically applicable for disability claims or travel claims.

Reasonable and customary charges apply to practitioner services such as these. Coverage for practitioners varies by province and provider and are generally updated annually. Check your benefits booklet or contact your benefits provider to confirm eligibility and coverage details for these services.

  1. If your claim is denied, request an explanation from your benefits provider (an EOB or Explanation of Benefits is usually produced automatically). Sometimes, claims are denied due to incomplete information or misunderstandings. Your benefits advisor can assist in resolving claim issues.

Yes, coordination of benefits (COB) allows you to maximize coverage if you are covered under more than one insurance plan. You’ll first send the claim to the plan you are a member of (primary coverage) for adjudication and payment. Then you can submit any eligible outstanding amount to your other (secondary) coverage. Coordinate with both insurers to ensure you receive the maximum allowable reimbursement for eligible expenses.

Further Reading

Lindsay Byrka

Lindsay Byrka BA, BEd, CFP

Vice President, Immix Group: An Employee Benefits Company
A Suite 450 – 888 Dunsmuir St. Vancouver V6C 3K4
O 604-688-5262 E lindsay@immixgroup.ca
W www.immixgroup.ca

Understanding Travel Insurance

Understanding Travel Insurance: Everything You Need to Know Before Takeoff

When we talk to groups of employees about their benefits coverage, one thing that pops up time after time is that employees are often unaware that their extended health care includes travel insurance!

Far too many employees have told us that they purchased travel insurance for a trip, as they either forgot or did not know that they and their family were adequately covered through their group insurance provider.


Do you already have emergency travel insurance in place?

Travel insurance is a common embedded feature of extended health insurance. Typically, it covers employees and their enrolled dependents (the key word here is “enrolled”- if your spouse or kids have waived this benefit line, they will not have travel coverage).

Generally speaking, travel insurance covers expenses relating to sudden, unexpected medical emergencies when traveling outside of your province and/or country of residence.

A claim through the travel insurance portion of the extended health care benefit could be as dramatic as an emergency room visit for a serious incident, or as simple as a forgotten prescription drug. Regardless, the cost of medical care in another country – most notoriously, in the United States- can be surprisingly expensive; you do not want to ever travel without ensuring you have coverage in place.


It’s more than just reimbursement for hospital bills

In addition to the obvious medical expenses one might incur for an illness or injury while travelling, there are usually additional embedded services included in a typical group travel plan such as:

  • Help with finding qualified medical practitioners, wherever you are
  • Help with lost baggage or stolen documents
  • Help in contacting family, legal services, or consular assistance
  • Assistance with transfer from one medical facility to another
  • Assistance with the arrangement of repatriation of remains in the event of death
  • Assistance with getting you home

Most importantly, the travel provider will coordinate the actual claim and will ensure the insurance carrier is properly notified, if applicable. Oftentimes, the provider will negotiate the cost of the medical expenses on your behalf, reducing the cost of the claim.

Most employee benefits insurance carriers use specialty travel insurance providers for this portion of their coverage. There are various reasons for this, including access to a worldwide network when it comes to handling claims situations.


Does the program provide enough coverage, or should I buy more coverage?

 Many travel insurance plans have very high limits; it is common to see $1M-$5M, usually expressed as a lifetime maximum per insured person. Some programs even have unlimited travel reimbursement. Within the policy, there may be limitations for specific items.

Most people feel this is an adequate amount of coverage for a typical vacation; however, if you still have concerns over the amounts, additional top-up coverage can be purchased.


Usually, there is no deductible

Travel insurance through a group benefit program usually comes with a $0 deductible; this means you are not out-of-pocket a certain amount before the coverage is applied to the expense.

Additionally, claims are what we refer to as ‘fully pooled.’ This means that the claims for emergency travel do not impact the claims experience for your benefit plan; while the Employer may see the dollar amount of the claim, the details and claimant will remain anonymous and the cost will not impact the renewal pricing calculation for the benefits program.


Are you travelling…or have you relocated?

Heading for an extended vacation? Be sure to check the travel duration limits on your program. It’s standard to see a 60-day travel duration included in a policy. What this means is that at day 61 (continuously away from place of residence) you are no longer insured under the travel insurance. Returning home for a single day will reset the duration count.

Have a lot of shorter trips planned? This is not a problem, as most plans do not quantify cumulative travel days, they define continuous travel.

Real Life Story

In one unfortunate incident, a member of a group plan we manage decided to extend his trip to Thailand multiple times but had failed to look into the details of the program in advance. He ended up in an emergency situation and was hospitalized for an extended period. The incident occurred on day 62 of his trip; the insurance carrier denied the claim as it was outside of their insured timeframe.

Some policies do allow for unlimited-duration travel, but this is rare. If you do plan to take an extended trip, make sure you understand your own coverage and if necessary, you purchase a top-up plan that starts when your other coverage ends.


Common emergency travel insurance clauses you need to understand

There are a few common clauses to be aware of, and to review within your own policy:

  • Most extended healthcare emergency out-of-country travel plans do not cover trip cancellation or trip interruption; these are not considered ‘medical’ and can usually be purchased in conjunction with your flight or travel package or on a stand-alone basis.
  • Most plans do not cover travel into locations with active travel advisories, into war zones, or emergencies arising from certain activities (participating in a riot, for example).
  • Are you pregnant? Most policies do not cover pregnancy past 32 weeks. We have all heard stories of pregnant women giving birth outside their home country, unexpectedly early, and the high associated medical bills. A pre-term birth would be covered (along with the expenses for the newborn) up to 32 weeks, but it is not standard to have insurance beyond this mark.
  • Lastly, and most importantly; does your policy contain a pre-existing conditions clause, and what is the exact wording around this? Earlier we stated travel medical policies cover “unexpected” medical expenses; pre-existing conditions, in general, are not considered to cause ‘unexpected’ medical situations, and therefore are often uninsured.


However, there are certain details to understand; it is possible for a pre-existing condition to be insured if it is stable and managed at the time you leave. For example, someone with high blood pressure or diabetes may still travel, and have an incident related to their pre-existing condition covered, if their medical emergency was unexpected because they were stable upon departure.

This is an area where it is essential to reach out to your provider in advance of your trip, declare your medical issues, and get their confirmation that you are covered.

Please note that while a pre-existing condition may not be covered, this does not mean you are not insured at all. For example, perhaps you have a pre-existing blood pressure condition that is not stable, as it is newly diagnosed. The insurance provider has confirmed to you that this would not be insured. If you decide to travel anyway, and you are in a car accident and break your leg, you would likely be insured for the visit for the broken leg, but not for anything relating to the blood pressure condition. The wording related to pre-existing conditions differs between insurers and understanding your own unique situation is crucial.


What to do if something happens while you’re traveling?

First of all, be proactive. The people you are traveling with should be aware of your insurance details, and vice versa. In a worst-case scenario, where someone needs emergency treatment, you may be required to provide proof of insurance to obtain treatment. In fact, many seasoned travelers wear medical bracelets that provide their basic information, including their travel insurance details!

Most employee benefits insurance carriers use specialty travel insurance providers for this portion of their coverage. There are many reasons for this, including access to a worldwide network when it comes to handling claims situations.

Open a claim as soon as possible. If you find yourself in a medical emergency, it’s very important to immediately provide your insurance information to the medical facility and to contact the insurance provider to open a claim. Wherever possible, avoid paying out-of-pocket even if it seems easier to just pay with a credit card, and worry about the claim later.

There are a couple of key reasons for this:

  • Reduced costs; the costs the insurance provider will negotiate (depending on the country, but commonly for the US) are often far lower than what they will charge you as a ‘cash payor.’
  • Simplified paperwork; if you return to Canada first, in most instances you need to file your claim first through provincial medical, and second through your travel provider. This is complex and can take months to resolve.
  • Access to services; involving the third-party emergency travel provider will allow you to gain access to the many services listed above; for example, they may recommend you transfer to a different medical facility.


Travel with confidence

The reality is emergencies happen, but with a bit of simple preparation, you can have the best case scenario in a medical emergency. Understanding the scope of your coverage and having all necessary information readily available can make all the difference in the event of an emergency while traveling.

To learn more about travel insurance or to explore group or individual coverage options, contact us at info@immixgroup.ca or give us a call at (604) 688-5559, we are happy to help!

Top 8 FAQ’s

Many employees are often unaware that their extended health care includes travel insurance, leading them to purchase additional coverage unnecessarily.

    • Travel insurance generally covers unexpected medical emergency expenses incurred during travel outside of one’s province or country of residence.

Additional services may include assistance in finding qualified medical practitioners, help with lost baggage or stolen documents, contacting family or legal services, arranging medical facility transfers, and repatriation of remains in the event of death.

Many policies do not cover trip cancellation or interruption, travels to locations with active travel advisories or war zones, or emergencies arising from certain activities.

Individuals should review their policy’s pre-existing conditions clause and ensure that their medical issues are declared and confirmed for coverage.

Travelers should immediately provide their insurance information to medical facilities, avoid paying out-of-pocket when possible, and contact their insurance provider to open a claim for assistance and guidance.

Most policies include a standard travel duration limit, commonly around 60 days, with continuous travel beyond this period potentially voiding coverage.

Some policies allow for unlimited-duration travel, although this is rare; for extended trips, individuals should understand their coverage and consider purchasing a top-up plan if necessary.

Further Reading

Lindsay Byrka

Lindsay Byrka BA, BEd, CFP

Vice President, Immix Group: An Employee Benefits Company
A Suite 450 – 888 Dunsmuir St. Vancouver V6C 3K4
O 604-688-5262 E lindsay@immixgroup.ca
W www.immixgroup.ca

Three Reasons to Implement a Group Savings Plan

We write often about Group Savings Plans, as it’s our belief that one of the best ways employers can assist their employees is by offering them the opportunity to plan and save for the future.

This is a sentiment that is echoed by many in our industry. In their recent 2023 recap, iA’s Director of Plan Member Wellness and Education stated the need to evolve our thinking when it comes to group savings programs, and more specifically, to “develop engagement strategies that focus on supporting people to achieve their personal goals.”

Our interpretation of this comment is that your purpose in setting up a Group Savings Plan should extend beyond simply finding a way to provide more funds to your team, or setting up a plan just because you need to be competitive with similar employers. Employees are self-reporting that they are feeling significant stress, and the number one reason is due to finances. It goes without saying that everyone has many and varied personal goals related to achieving financial peace of mind.

The three reasons to implement a group savings plan we are focusing on here focus on these facts: the support is needed, the tactic is effective, and implementation is simple.



1. Employees need support when it comes to financial literacy training and tactics to get them on track in this area of their lives


As we wrote about previously, a Group Savings Plan targets a key stressor for employees- their finances. The stats are clear, as reported via the 2023 Benefits Canada survey as well as through the Financial Consumer Agency of Canada:

  • 32% of Canadians report feeling a high level of anxiety, stress, or worry over money.
  • Only 49% of Canadians describe themselves as financially knowledgeable.
  • 36% feel they are just getting by, financially speaking.
  • 67% of Canadians said their debt increased by more than $5,000 in the past 12 months.
  • 53% have an emergency fund (2023), down from 64% in 2019.

As the image from the Benefits Canada Survey shows, “Personal Finances” continues to rank #1, followed by Workload and Work-Life Balance.

Screenshot 2024 02 29 at 10.04.40 PM

The answer is not simply to ‘pay people more’. Equipping people with the ability to save in a systematic and tax-effective manner, and contributing to these savings through an Employer match goes a long way. Additionally, and most importantly, Group Savings Programs provide employees access to education resources, planning tools, and financial advisors that they may otherwise not bother to seek out. Access to financial advisors to help employees achieve their personal financial goals, even if it’s as simple as developing a budget to assist with living within one’s means, can create a lasting impact and potentially redirect the trajectory of one’s financial future.

Simply put, a Group Savings Program is an opportunity to assist your employees where they need it most.


2. It provides an immediate, twofold beneficial impact as savings grow and taxes are reduced


Contributions to an RRSP (Registered Retirement Savings Plan) reduce taxable income. The difference with a Group Savings Plan is that contributions are made directly via payroll deductions.  When employees contribute to an RRSP directly from their paycheque, they experience income tax savings in real-time, as they are taxed on their after-contribution income.

We mentioned earlier the perspective that employers should seek strategies to assist employees in reaching their personal goals. Many employees identify financial goals, and particularly the development of a retirement savings account, as incredibly important.

Over time, and with engagement with the many planning tools available, an employer-sponsored program assists in creating a sense of achievement and tangible progress as retirement savings grow.

An added bonus? The Employer contribution. While not mandatory, this of course serves to boost an employee’s account value, taking them more quickly towards their goal.


3. Simple, low touch, high ROI


Lastly, it cannot be overstated how simple it can be to implement and manage a group savings plan. In contrast to the requirements of a pension plan, a simple group RRSP or group RRSP-DPSP combination plan is very low touch from an administrative perspective.

Even a very small employer can easily implement a Group Savings Plan that provides similar access to all the features (online platform, resources, investment funds, planning tools, etc.) that a much larger employer offer. It’s a way to recruit, retain, and remain competitive. In short, implementing a group savings plan provides a great return on investment.

Already have a group savings plan in place? Here are a few checkups:

  • Have you taken advantage of our offer to host an education seminar?
  • When was the last time you assessed the contribution level made by the Employer? Has it kept pace with inflation?
  • When was the last time you reviewed Employee contribution levels? Have employees been reminded that they can increase their payroll deductions, again, to keep pace with inflation or changing circumstances?
  • When did you last run an audit of participation levels? Is everyone who is eligible to participate enrolled?
  • Are you aware of and communicating the many comprehensive resources available through your provider and advisor?

Help employees to save for the future


In summary, implementing a Group Savings Plan is a direct response to the financial stress reported by employees. Beyond immediate benefits like tax-effective contributions and employer matches, it offers a straightforward and high-return solution to recruit, retain, and stay competitive. By addressing employees’ financial concerns holistically, it not only eases stress but also fosters financial growth and supports personal goals.

At the Immix Group, we recognize the importance of financial literacy which is why we offer lunch and learn seminars where we explain, simplify, and guide our clients through their programs to help them maximize their benefits. Additionally, our clients have direct access to our sister company, Ciccone McKay Financial Group, where dedicated advisors are available and ready to provide personalized assistance.

It’s desired, it’s beneficial, and it’s simple to implement and administer! If it’s been on your mind to look into a plan for your employees, we’re happy to help you discuss options.


Beyond just funding your team or competing with other employers, it addresses the top stressor reported by employees—financial concerns.

By enabling systematic savings and offering tax-effective contributions, it directly tackles the rising anxiety and lack of financial knowledge reported by Canadians. It also provides employees access to education resources, planning tools, and financial advisors that they may otherwise not bother to seek out.

It offers real-time income tax savings as contributions are made directly from paycheques, creating tangible progress toward personal financial goals.

While not mandatory, this of course serves to boost an employee’s account value, taking them more quickly towards their goal.

It’s simple, low-touch, and offers a high return on investment, making it easy for employers to implement and manage.

It requires minimal administrative effort, making it accessible even for small employers to provide features similar to larger employers.

Implementing a Group Savings Plan enhances competitiveness, contributing to employee satisfaction and loyalty.

Regularly assess Employer and Employee contributions, participation levels, and leverage available resources for ongoing plan success.

Further Reading

Key Conversations in Benefits 2023

Employee Benefits Conversations

Last year our blog “Top Conversations of 2022” proved to be among our most popular articles for the year! Once again, this year, we have compiled a recap of the Top Conversations in Benefits, from our perspective as benefits advisors.

Last year we recapped the top conversations in benefits, which can be summarized as:

  • The ongoing extreme difficulty in hiring reliable, qualified staff;
  • The permanent shift to a hybrid work arrangement;
  • The “Great Resignation” or rather, in Canada the “Great Retirement;”
  • The brand new Federal Dental Plan;
  • The change to the duration of EI Sickness benefits;
  • The continued focus on mental health and wellbeing;
  • And lastly, high inflation.

Has it Become Easier to Hire Great People?

According to experts, we should expect the unemployment rate to rise, with the population increasing at levels that are outpacing hiring, due to the arrival of many newcomers. With the job vacancy rate down, employers are able to be more selective with hiring. While this may sound like great news, we are still hearing from our Client Community that it is incredibly challenging to find skilled, reliable employees.


Remote or Hybrid Work Arrangements are Still a Key Request for Job Seekers

Related to this, we saw many in our Client Community move to remote workforces or hybrid workforces; not as a hangover from the requirements of the pandemic, but as a desired new norm. The recruiters in our network tell us this is still in the top 2 or 3 for job requirements for job seekers these days.

We wrote about this extensively back in 2022, in our two-part article ‘Is Working from Home an Employee Benefit?” where we looked at many of the considerations and statistics surrounding the (at the time) new reality.


Inflation is Impacting Benefits Costs

We touched on inflation in our January 2023 recap, but this became the dominating topic of many benefits conversations as we saw costs increase across a wide spectrum of services: practitioner visits, equipment, drugs, and dental costs. While it’s easy to blame inflation on the rising cost of benefits, the reality is that insurance providers are paying higher per-claim costs in many instances, even when coinsurance and maximum reimbursement limits are in place. This especially impacted dental claim costs, and unfortunately, we anticipate the dental fee guide to increase once again in 2024. The bottom line? Inflation is affecting everyone. This is a global economic issue and is certainly not isolated to those of us here in Canada.

Related to inflation and hiring, wage increases are expected to be modest this year, and economists are not expecting to see wage costs as a notable factor in driving inflation.


Pay Transparency Legislation Implemented

It will be interesting to see the potential impacts of pay transparency legislation taking effect in some provinces, including BC. Will pay transparency legislation drive wages up?

With the stated goal of closing the gender pay gap, effective for November 1st 2023, employers were required to post salary ranges for publicly advertised jobs. Furthermore, employers will be required to publicly post gender pay gaps (staggered based on the size of the company, beginning now, and expanding to smaller companies through to 2026.  The stated goal is to reduce unconscious bias around gender and ethnicity.


How Should the Employer and the Employee Split the Cost of Benefits?

In 2023, we received many requests for advice and changes related to the sharing of benefits premiums between employers and employees.

Many employers made adjustments this year. For some, in an effort to reduce the burden placed on employees, employers were shifting a greater percentage of the cost to the employer. Other employers went the other direction, looking to see employees cover a great percentage of their benefits premiums. As a reminder, the employer must cover no less than 50% of the total cost of benefits, and tax efficiency is an important consideration when arranging your cost split. We wrote about strategies and common practices back at the end of 2023.


Federal Adjustments: EI Sickness Benefits and Long-Term Disability 

The change to EI Sickness benefits via Service Canada which saw the maximum payment period increased from 15 weeks to 26 weeks (6 months), resulted in very little disruption for those with Long Term Disability plans in place. The vast majority of employers kept their Long Term Disability benefits intact with the waiting period at the standard 119 days/ 17 weeks. While this was matched to the previous EI Sickness benefits duration, employers agreed that it was more desirable to have employees move more quickly to long term disability benefits rather than remain on the more limited EI Sickness benefits. Additionally, there were negligible cost savings in adjusting the Long Term Disability waiting period. 


The Federal Dental Plan and T4 Reporting Requirements

After years of discussion and development the Federal government launched the Federal Dental Plan, providing coverage for children under 12 only. In order to qualify for any level of coverage, family income must be under $90K, and the children must not have access to private dental coverage (i.e. Employer plans).

As a result of this program, on 2023 T4’s Employers are required to report on Box 45 whether as of December 31st, 2023, their employees were ‘eligible to access dental insurance or dental coverage of any kind, including health spending and wellness accounts, due to their current or former employment”.

The following codes are to be used:

  • Not eligible to access any dental care insurance, or coverage of dental services of any kind
  • Payee only
  • Payee, spouse, and dependent children
  • Payee and their spouse
  • Payee and their dependent children


Please note if you have a benefits program that provides dental coverage, the vast majority of employers will report code 3 “Payee, spouse and dependent children.”

The codes above have created a lot of confusion, as they are based on access and not actual enrolment in the benefit for all eligible individuals within the family unit. Specially, if a plan offers family coverage but the member has waived benefits for either themselves or family members, Code 3 still applies as that is the type of coverage available. 

Please note employees must have been eligible for coverage as of December 31st, 2023, for Code 3 to apply (i.e. not still in the waiting period). 

As expected, the Federal Dental plan did not impact existing employer-sponsored dental plans, but changes may be coming, given this was indicated as the first stage in a more comprehensive Federal program.


Mental Health Support Discussions Continue to Expand and Evolve

When it comes to discussions with our supplier partners (i.e. providers such as Manulife, RBC Insurance, Pacific Blue Cross, Canada Life and myHSA), we have noticed a movement towards branding themselves as health and wellness driven. More and more services are geared at healthy living, whether this is aimed at improving activity levels, diet and prominently, mental health. In many instances, they are tapping into the data they have on hand to produce customized solutions.

A cornerstone of this is mental health support; all carriers are providing resources and coverage solutions. This is an area where we continue to see plan sponsors increasing their coverage, along with their communication and promotion of available services. Employers added to their mental health offerings in a variety of ways, most commonly:

  • Adding Health/ Wellness Spending accounts to remove financial barriers to mental health practitioners
  • Adding or promoting Employee & Family Assistance Programs
  • Ensuring coverage for applicable practitioners with paramedical services: psychologist, clinical counsellor, social worker
  • Enhancing coverage for the paramedical practitioners with higher limits.

The availability of online, high quality and often free resources is enormous and continuously evolving.


An Emerging Trend: Inclusive Coverages

As iA stated in a January 18th communication “today’s employees expect their organization to support them fully in their multiple and diverse needs.” For providers, conversations have focused on a few key areas:   

Gender Affirmation: the cost for gender affirmation procedures not covered under provincial medical has been widely discussed the past few years, and we now have providers including this coverage. For example, Equitable Life rolled this coverage out late 2022, with the stated aim of “offering solutions that support diversity, equity and inclusion.” We expect to see more providers rolling out gender affirmation coverages.

Fertility, Surrogacy, Adoption: despite fertility problems affecting one in six couples hoping to conceive, fertility coverage has traditionally been limited to drugs and often with a defined annual limit. A concern for many was uncovered related costs, such as for procedures.

iA is one provider that has provided what they call “Family Support” coverage, where in addition to drugs, care and treatments such as doctors’ fees and lab services, are also covered, including for surrogates.  Additionally, on an ASO basis, iA is offering Adoption coverage for costs related to the adoption of a child.

While many of these costs have been eligible through Health and Wellness Spending Accounts, it is new to see insurance providers identifying and defining these coverage areas.


Diabetes and Adult ADHD Medications on the Rise

Adult ADHD claims have steadily increased over the past several years. We now routinely see Vyvanse, a leading amphetamine-based drug for ADHD as one of the top claimed medications for the employers with whom we work. As Manulife shared, this is “recognized more widely as a condition that continues into adulthood.” In short, the kids diagnosed and medicated for ADHD are now adults, who have continued to be medicated. In addition to this, there is major rise in adult diagnosis of ADHD, which is being credited in part to increased awareness through social media. In particular, there is an increased diagnosis for women, as we now have a greater understanding of how differently the symptoms present in men vs women.

Diabetes has been on the rise for many years now; 30% (12M Canadians) live with diabetes or prediabetes, with over 90% Type 2. As well, the data shows diabetes diagnoses are increasing among younger age groups.  We are seeing diabetes medications such as Jardiance, Trulicity and Metformin continually in the top ten claimed drugs for many clients.


Ozempic Dominates Drug Conversations

But without a doubt 2023’s “most frequently asked question” relates to the costly Type 2 diabetes medication Ozempic (Semaglutide) which is a daily injectable. This blockbuster drug is approved in Canada for the management of Type 2 diabetes; however, it is extremely popular for its well-known side effect, weight loss. This drug was all over the news, with celebrities endorsing it for its ability to curb one’s appetite, leading to quick and significant weight loss.

In short, members wanted to gain access to the drug, most often for weight-loss purposes. However, the drug here is BC requires Special Authority approval. To be approved, you must require it for treatment of type 2 diabetes, “After inadequate glycemic control on maximum tolerated dose of metformin.” Unfortunately, in Canada, getting Ozempic is not as simple as just requesting it from your doctor!


What to Expect for 2024?

Here at the Immix Group, 2024 has been very busy so far! Many employers are asking for ideas to better meet the needs of their employees, and looking for details on what their employees are claiming in order to better customize their benefits offerings.

We unfortunately continue to see claims rising and expect this to continue through 2024, and therefore expect to have many conversations with employers regarding cost containment strategies.

As always, we welcome you to reach out to discuss optimization strategies for your benefits programs.


The key topics revolved around the challenges in hiring, the shift to hybrid work arrangements, the “Great Retirement,” the Federal Dental Plan, changes to EI Sickness benefits, a focus on mental health, and the impact of high inflation.

Employers are able to be more selective, with many newcomers meaning there are many job seekers; however, employers are still reporting a difficulty in finding skilled employees.

Yes, remote or hybrid work arrangements continue to be a top priority for job seekers, indicating a shift from a pandemic necessity to a desired norm.

Inflation has driven up costs across various services, impacting practitioner visits, equipment, drugs, and dental expenses. Insurance providers are facing higher per-claim costs, especially in dental claim costs.

Pay transparency legislation, effective from November 1st, 2023, requires employers to post salary ranges for publicly advertised jobs in an effort to close the gender pay gap.

Many employers adjusted their benefits cost-sharing strategies in 2023. While some shifted more costs to employers, others leaned towards employees covering a greater percentage. Employers must cover at least 50% of the total benefit cost.

EI Sickness benefits saw an increase in the maximum payment period to 26 weeks (end of 2022). This change had minimal disruption for those with Long Term Disability plans, with waiting periods mostly unaffected.

Employers must report on Box 45 of 2023 T4s whether employees were eligible for dental coverage as of December 31, 2023. Specific codes are provided for different eligibility scenarios.

Carriers are increasingly focusing on mental health, providing resources and coverage solutions. Employers enhance mental health offerings through various means, including Health/Wellness Spending accounts and Employee & Family Assistance Programs.

There is a growing trend towards inclusive coverages, including gender affirmation procedures, fertility, surrogacy, adoption, aiming to support diverse needs and promote diversity, equity, and inclusion.

Adult ADHD claims have increased steadily, with a rise in adult diagnoses, attributed to increased awareness. Diabetes diagnoses, particularly Type 2, are on the rise, impacting medication claims. The most frequently asked question is about the costly Type 2 diabetes medication Ozempic (Semaglutide), frequently sought for its weight-loss side effect.

Lindsay Byrka

Lindsay Byrka BA, BEd, CFP

Vice President, Immix Group: An Employee Benefits Company
A Suite 450 – 888 Dunsmuir St. Vancouver V6C 3K4
O 604-688-5262 E lindsay@immixgroup.ca
W www.immixgroup.ca

Understanding Cost-Sharing in Employee Benefits

Understanding Cost-Sharing in Employee Benefits: The Employer’s Role in Premium Contributions and Standard Practices



In the fiercely competitive job market, employee benefits play a crucial role in attracting and retaining top talent. Among the many decisions that employers face in crafting an appealing benefits package, one of the most significant is determining the benefits premium cost-sharing arrangement between the company and its employees.

This article aims to delve into the complexities of ‘cost-sharing’ and shed light on standard practices for designing sustainable and attractive employee benefit programs.

Firstly, if you were not aware, it’s quite common for part of the cost of the benefits program to be paid for by employees via payroll deduction. This is typically a ‘condition of employment’ and is outlined in a contract of employment. Premium amounts can vary significantly depending on the scope of the program, the demographics of the group and other factors, meaning the dollar amount of the payroll deduction can differ significantly from employer to employer. No greater than 50% of the overall cost can be passed along to the employee, per insurer guidelines. The “cost sharing” per benefit line is indicated to the insurance carrier at the implementation of a program, and most carriers will indicate the “employee” and the “employer” premiums, per benefit line, on each monthly invoice simply to assist with payroll.


What should Employers consider when determining cost-sharing?

The cost-sharing ratio between employers and employees is not a one-size-fits-all equation. It depends on a multitude of factors, including:

  • the size of the company,
  • plan design,
  • the premiums in dollars for various benefit lines,
  • demographics,
  • employee classifications,
  • and of notable importance, the tax implications.

Striking the right balance requires careful consideration, and the differing taxation of various benefits (link to taxation of benefits page) is usually one of the primary considerations.


Three different ways to view Cost Sharing:

An employer might approach cost sharing by considering the benefits to be covered by the employee:

  • Employee pays Long Term Disability premiums only
  • Employee pays all pooled benefits premiums (Life, AD&D, Disability and Critical Illness).
  • Employee pays all pooled benefits premiums plus 50% of health and dental premiums

In all the above scenarios, the Employer must ensure that no greater than 50% of the overall cost is passed along to the employee.

Alternatively, the employer might apply a percentage to the entire cost of the program, with the maximum allowable percentage of 50%. For example:

  • Employee pays 25% of total premium costs.
  • Employee pays 50% of total premium costs

In the event that a percentage is applied, the premium should be applied first towards the benefits for which an employee-paid premium ensures a tax-free benefit (most notably, Long Term Disability). The tax implications of cost sharing should be carefully considered in order to reduce or eliminate the possibility of a taxable benefit.

Less commonly, an employer might charge a flat dollar amount:

  • Employee pays $25 per pay period towards benefit premiums
  • Employee pays $100 a month towards benefits premiums

Regardless of the approach to cost sharing, the formula must be viewed with the actual dollar amount of premiums taken into consideration, per benefit line.


How should an organization approach cost-sharing? What is typical?

As mentioned, it is essential to understand the cost for the various benefit lines (and yes, these change year to year!) and the tax implications. In addition, employers must consider how their cost-sharing arrangement compares to their industry, and to their particular company’s philosophy. Beyond the tax implications, there are several factors that influence the cost-sharing structure:

  1. Plan Design: The specific design of the benefits plan can impact the appropriate cost-sharing scenario. For example, a plan with high life and disability coverage may see higher premiums for these benefits.  If the employee is covering these premiums for tax reasons, the employer may wish to cover 100% of the remaining benefits.
  2. Industry Norms: Employers often look to industry benchmarks to ensure their contribution levels remain competitive and appealing to potential employees; what are your main competitors doing? If your primary competitors are advertising that they cover 100% of benefit premiums, you may need to follow suit.  
  3. Company Size and Financial Resources: The financial capabilities of the company, combined with its size, can influence the employer’s ability to contribute significantly. Generally speaking, larger, most established companies tend to cover a greater share of benefit costs, because they can afford to do so. 
  4. Talent Demand: In high-demand talent markets, employers may need to offer higher contribution levels to attract and retain top performers, in addition to offering a more comprehensive program.
  5. Company Philosophy: what are the core values of your company, and how does your cost-sharing formula fit into this?


Balancing Employee Needs and Cost Containment

Employers face the delicate challenge of balancing attractive benefits with cost containment. While it is vital to provide robust benefits that meet the diverse needs of employees, it is equally crucial to manage expenses efficiently.

Beyond the cost-sharing of the premiums, please keep in mind that the plan design itself offers an element of “cost-sharing” through coinsurance and deductibles, and additionally, through reimbursement limits. Please consider:

  1. Deductibles: flat deductibles are paid out-of-pocket before coverage is applied; while deductibles can incentivize employees to be more conscious of their benefit usage, thus reducing unnecessary expenses, they penalize lower claimers and are less common these days.
  2. Co-Insurance: this refers to the percentage of coverage, such as “80%” for basic dental. Co-insurance requires employees to share a portion of the costs for specific services, encouraging them to make more informed healthcare choices.
  3. Reimbursement limits; items may have limits that leave the employee out-of-pocket for the remainder of the cost (i.e. orthotics that cost $500 for which the employee only receives $300 back). Potentially in combination with points 1. and 2. above, reimbursement limits can erode the overall percentage of an expense for which an employee is covered. 

All of the above can encourage employees to make informed choices when it comes to their healthcare spending. However, with most employers stating that the overall goal of a benefits program is to facilitate employee health and wellness, employers should be mindful that employees are not bearing too great of a costs for their coverage, from a holistic perspective.

As we said, approaching the cost-sharing that is right for your company is not one-size-fits-all; you need to carefully consider the factors outlined above, and work with an experienced advisor to ensure the right approach that allows for excellent coverage in combination with cost-sustainability.


Decoding cost-sharing in employee benefits is a complex task that demands careful consideration of multiple factors. Employers must keep abreast of industry trends, assess their financial resources, and regularly evaluate their benefit packages to ensure competitiveness and relevance in the job market.
In today’s competitive landscape, employers must recognize that ongoing evaluation and adjustment of benefits packages are necessary to attract and retain top talent. By striking the right balance between attractive benefits and cost containment, employers can demonstrate their commitment to their workforce’s well-being while maintaining financial sustainability. The key lies in crafting a benefits package that aligns with the company’s values, meets the evolving needs of their employees, and supports the organization’s overall goals.


Cost-sharing in employee benefits refers to the arrangement where both the employer and the employee contribute to the cost of the benefits program. It helps strike a balance between providing attractive benefits and managing expenses.

Several factors influence the cost-sharing ratio, including company size, plan design, benefit premiums, demographics, employee classifications, and tax implications. Striking the right balance is crucial for an effective cost-sharing strategy.

Employers can approach cost-sharing by considering the benefits to be covered by the employee, applying a percentage to the total premium costs, or charging a flat dollar amount. Each approach has its considerations and implications.

Industry benchmarks and norms are essential considerations when determining cost-sharing arrangements. Employers often align their contribution levels with industry standards to remain competitive and appealing to potential employees.

Employers must balance attractive benefits with cost containment strategies. This includes considering elements like deductibles, co-insurance, reimbursement limits, and designing a benefits program that promotes employee health while managing expenses efficiently.

The ultimate goal of a benefits program, including cost-sharing strategies, is to facilitate employee health and wellness while ensuring employees are not burdened by excessive costs. It’s about providing excellent coverage in a sustainable manner.

Employers should regularly evaluate industry trends, assess their financial resources, and work with experienced advisors to ensure their cost-sharing approach aligns with industry standards and meets the needs of their workforce.

Decoding cost-sharing in employee benefits requires careful consideration of multiple factors. Employers need to maintain an ongoing evaluation and adjustment of benefits packages to attract and retain top talent while ensuring financial sustainability. The key is crafting a benefits package aligned with company values and employee needs.

Key Takeaways
  1. Importance of Cost-Sharing: Cost-sharing in employee benefits is a vital strategy that helps strike a balance between providing attractive benefits and managing expenses, ensuring both employers and employees contribute to the cost of the benefits program.

  2. Factors Influencing Cost-Sharing: Several factors, including company size, plan design, benefit premiums, demographics, and industry norms, influence the cost-sharing ratio between employers and employees. Employers must carefully consider these factors to determine an effective cost-sharing arrangement.

  3. Diverse Approaches to Cost-Sharing: Employers can approach cost-sharing in different ways, such as defining specific benefits for employee contribution, applying a percentage to total premium costs, or charging a flat dollar amount. Each approach has its considerations and implications.

  4. Balancing Employee Needs and Cost Containment: Employers face the challenge of balancing attractive benefits with cost containment. Elements like deductibles, co-insurance, and reimbursement limits play a crucial role in promoting informed healthcare choices while managing costs effectively.

  5. Ongoing Evaluation and Adaptation: Employers must regularly evaluate industry trends, assess their financial resources, and work with experienced advisors to ensure their cost-sharing approach remains competitive and relevant. It’s essential to align the benefits package with company values and the evolving needs of employees for long-term success.

Howard 2

A Proven Strategy for Containing Employee Benefit Plan Costs

A Proven Strategy for Containing Employee Benefit Plan Costs

With elevated inflation causing everyone to take a closer look at their expenses, we wanted to introduce (and remind those who are already members of the Immix Group Client Community!) the many advantages of our broker-managed pools.

Table of Contents

Back in May 2020, we wrote about the value of benefits inside a broker managed pool, especially during times of uncertainty. With inflation hitting everything, the markets so volatile, interest rates and business expenses increasing, benefits cost containment is more crucial than ever.

Our stance then- and now- is that belonging to a broker-managed pricing pool is an extremely beneficial strategy for the majority of our clients at the Immix Group.

Our stance then- and now- is that belonging to a broker-managed pricing pool is an extremely beneficial strategy for the majority of our clients at the Immix Group.

What does this mean? It means for most of our client’s benefit programs, the Immix Group sets the pricing at renewal, and often at the onset of the plan as well. The rates are based on predetermined administrative charges and other factors that are more competitive than a group could obtain outside of the unique strategy we have created.  

This stands in contrast to groups insured on a stand-alone basis, where pricing is negotiated back and forth on individual renewals with the insurance provider.


Broker-Managed Pools through the Immix Group: Proven Results

Those in the Immix Group Client Community have greatly benefited from our strategy of broker-managed pricing pools. As we wrote about previously, a review of our block of business showed the following results for our 2022 renewal rates:

  • 43% of our clients saw a reduction to their Extended Health Care rates
  • 30% of our clients saw a reduction to the Dental Care rates
  • 75% of our clients saw their pooled rates held without change

Despite the high inflation we saw in 2022, those within our broker-managed pools fared very well. This has been the case for many years; one of our pools now has an 18-year track record of providing cost containment to its member groups.

Immix Pool makes sense

The 5 Key Advantages of the Immix Pool

The main advantages of our strategy? We’ve categorized the key benefits of our broker-managed pool strategy into 5 distinct areas:

  • Transparency- when it comes to the claims experience and rate calculations for your group.
  • Diversity – be grouped with an entire range of industries to spread the risk.
  • Buying Power- leverage economies of scale when it comes to plan design opportunities.
  • Service- we handle almost everything in-house, without TPA charges.
  • Reduced Administrative Charges- access to the low admin charges usually reserved for just the largest groups, rate guarantees, and customized pricing plans.


Transparency is a Key Value at Immix Group

One of the biggest misconceptions of a ‘pool’ is that you will not be able to see the details of your groups claims, and that your rate adjustments will be based on ‘the block’ perhaps leaving you in an unfair position. This is not the case with how our pools are designed; each group is experience-rated, with claims details clearly shown. In those high-claim years, you have downside protection and flexibility.


Diversity of Member Groups Means Greater Risk Management

We want to include groups of all sorts of backgrounds; construction, tech, professional services, retail and hospitality. This proved to be a great strategy during the pandemic where the strength of our pools allowed us to protect and continue coverage for those experiencing extreme disruptions to their businesses, employees and cashflow.


Power to Access Competitive Coverage for Small Groups

You may think you’re not a big enough group for disability, certain dental benefits or certain paramedical coverage levels. Inside the Immix Group pools, we have additional buying power when it comes to providing extremely competitive benefits to even very small groups.


Service by the Immix Group: An Extension of your HR Team

The Immix Group understands that for many smaller businesses, you do not have a dedicated HR team. For businesses that do, HR often prefers to focus on more essential matters than daily benefits management; our service model means we are able to handle the majority of the daily admin for your program, at no additional cost, and to provide our expertise when challenging employee situations arise.


Reduced Administrative Charges

Because the Immix Group has taken on the bulk of daily servicing and removed the requirement for the insurance carrier to create renewal documents, our clients receive much lower administrative charges than they could obtain as a stand-alone group. This translates into the ability to spend more in claims, compared to the premiums you’ve paid, than under a typical stand-alone plan. This means more of your benefits dollars go straight to paying claims for members, NOT to the insurance provider for expenses or profit. Think of it as wholesale pricing, but with the same coverage options of a custom plan, combined with the enhanced service experience the Immix Group strives to achieve on a daily basis.

As we’ve written, one size does not fit all!

A common question we get is about plan design: rest assured; you can customize your plan to meet the needs of your team. Unlike many other pools, the Immix Group does not require you to select from pre-determined plans. Immix will guide you in choosing the right plan for your team; we can survey and benchmark and determine the best fit within your budget.


How can belonging to the Immix Group’s broker-managed pool help a business to control costs?

Lastly, we wanted to share a story that illustrate how we have been able to assist clients within our broker-managed pools.

A long-time manufacturing client was hit with a series of very unexpected events that caused a significant downturn to their business. With high employee turnover occurring in connection with this, the business found itself in a terrible financial situation. Their employee benefits claims were much higher than in previous years (tied to the turnover, but also the coincidental timing of many new high cost claims), and we calculated an increase to their costs of around 35%. This cost increase was simply not feasible for the business to take on. But as a family-owned multi-generation business, the last thing they wanted to do was significantly reduce the coverage or cancel their benefits.

Because they were within the Immix Group’s pool where we ‘hold the pen’ when it comes to their rates, we were able to hold the costs for a year, and implement a 3-year plan to adjust the premiums to the levels required to properly fund the claims. This gave them time to get their financial footing, and to also address some of the causes of the high claims, with our assistance.

Ten years later, the client is still insured within our Immix Group pricing pool; they have grown and are thriving. As they achieved stability, so did their benefits costs. Over ten years, they have never had a renewal rate increase over 5%.

While this is one example, similar situations occur every year, where we are able to assist businesses to control this area of their balance sheet.

Still have questions? Interested in learning more? The benefits advisors at the Immix Group would love to help you optimize your benefits program. We love to hear from you!

“When it comes to managing employee benefit program costs, we learned a long time ago that the key to long-term cost control is to leverage the buying power of a large and diverse group of businesses. Working with- not against- our chosen insurance providers, we are able to provide sustainable, cost-effective employee benefit solutions to businesses both large and small. We created our first broker-managed pool nearly 20 years ago, and over this time the advantages for those in our Client Community have grown and grown.”

Key Takeaways

The Immix Group has longstanding broker-managed pools that provide lower employee benefits administration costs to small and medium-sized businesses.

Belonging to an Immix Group pool means full transparency as to your group benefits claims experience.

You can customize your plan design, while still benefiting from the advantages of belonging to a pool.

Lower administrative costs mean more of your employee benefits premiums go towards paying claims for your employees.

The Immix Group employee benefits model provides sustainable, long-term cost control, rather than the short-term reduced premiums that are available when switching insurers.

Asked Questions

For many groups (typically under 100 lives, but sometimes even higher!) the administrative costs for an insurer to run your program on a stand-alone basis are higher than if your program is within a pool, where admin costs are negotiated and applied on an aggregate basis.

This means that the pricing for the groups within the pool is set by the Immix Group, rather than by the insurance carrier who underwrites the benefits and pays the claims.

No, you can completely customize your plan coverage to match the requirements of your business, within the parameters offered through the insurance carrier.   

Yes, savings are typically available even for large groups, as administrative costs are often lower than stand-alone pricing. As well, because the Immix Group ‘holds the pen’ when it comes to your renewal pricing, we have flexibility to adjust the rates to a competitive level.

Further Reading

Lindsay Byrka

Lindsay Byrka BA, BEd, CFP

Vice President, Immix Group: An Employee Benefits Company
A Suite 450 – 888 Dunsmuir St. Vancouver V6C 3K4
O 604-688-5262 E lindsay@immixgroup.ca
W www.immixgroup.ca

Virtual Health Care is Everywhere

Virtual Health Care is Everywhere: Employer vs. Free Options, and the latest in Offerings.  

Back in 2020, we wrote about virtual care offerings, at the time prompted by the pandemic and the lockdown we were experiencing, which made routine doctor visits close to impossible.

While virtual care was available pre-pandemic (in fact, it dates back to around 2006), it was inconsistent and sometimes difficult to navigate. One silver lining of the pandemic is that the virtual healthcare space has exploded with new and expanded platforms, offering individuals and businesses a variety of options to meet a range of needs.

The shortage of family medicine providers, compounded by a severe cold and flu season has made virtual care offerings even more valuable in recent months. A huge number of Canadians do not have a family doctor, and for those that do, booking a same-day appointment is often extremely difficult, if not impossible. While an in-person visit is certainly warranted in many instances, sometimes a virtual visit will suffice, and it can definitely be more convenient: no commuting, parking, waiting rooms.

Studies show that over 50% of doctor’s visits could be handled without direct contact, meaning a virtual visit will suffice to resolve the concern. Through most virtual providers, you can access:

  • Diagnoses
  • Prescriptions
  • Sick Notes
  • Lab work orders, such as blood tests
  • Referrals to specialists
  • Imaging referrals (Xray, Ultrasound)
  • Mental health inquires and referrals

While all providers prescribe medications, they do not prescribe or refill narcotics and addictive controlled substances.

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Free vs Paid Options

You may have noticed the existence of free virtual health care offerings versus paid programs that can be purchased either by businesses for their employees, or even by individuals.

Why pay for a Virtual Health Program, with so many free options?

Employers can add Virtual Care programs to their benefits line-up. A typical paid employer-sponsored program means an enhanced experience, such as:

  • Wait times: free options are becoming heavily used, and wait times are becoming longer. Paid options guarantee quicker access.
  • Longer hours of availability; many paid options offer 24-7 care, in contrast to free versions.
  • Coverage for those in provinces/territories where virtual visits are not insured: currently only BC, Ontario, Alberta and Quebec cover virtual doctors visits under provincial care
  • Direct access to many specialists: often common specialists like dermatologists or pediatricians can be accessed through enhanced programs
  • Beyond regular medical doctor’s visits: practitioners are often available through enhanced paid programs such as counsellors and dieticians, naturopaths and most notably, mental health services.
  • Reporting: usage / ROI data is available through some providers

While the cost ranges, many of these programs are available as add-ons to your existing benefits program for a few dollars per employee, per month.

For example, Manulife’s program is provided through Telus Virtual Health Care and is available as an add-on to an insured plan for $3.95 per employee per month. Like other similar programs, it offers an app with 24-7 on-demand access to health providers via secure text, video, and live chat. Maple Virtual Health is another well-known and highly regarded offering that is also available through many insurance providers (RBC Insurance, for example). Maple Virtual Health can also be purchased stand-alone by employers, and it does provide some ability for free visits to non-members in qualifying provinces, but they are tapering this back to focus on employer-sponsored programs. Telus Health is the best known and largest of the virtual health platforms and offers employer-sponsored programs. It is worth noting that Telus Business mobility customers have access to the paid version of the Virtual Care program for free!
Virtual Health Care is Everywhere: Employer vs. Free Options, and the latest in Offerings

Free Virtual Healthcare Options

Depending on your province of residence, you may be able to access free doctor’s visits through some virtual providers. Some provinces cover virtual doctor visits, meaning you will pay no fee to access a doctor online (the doctor will bill the province, as they usually would with an in-person visit).

For residents of BC, Alberta, Ontario and Quebec, visits are free under some platforms. For those in other provinces, accessing a virtual provider typically costs around $30-40 per visit.

Most of these virtual providers connect via phone, live chat, video or secure text in order to connect with patients. The following are two notable virtual health care providers:

  • Telus Health – Telus has acquired numerous other providers and continues to dominate the virtual healthcare landscape. As mentioned previously, Telus Business mobility customers have access to the paid version of the Virtual Care program for free. The Telus Health MyCare app can be downloaded for free, and in covered provinces, doctor’s visits are billed to the province.
  • Tia Health One of the most well known and highly regarded platforms, with an easy to navigate system, Tia offers access to doctors, nurses and pharmacists by phone, video or secure messaging. Tia has also acquired a number of other virtual health providers, so has greatly expanded its network of clinicians.
  • Well Health Virtual Clinic Branded as a virtual walk-in clinic, this provider focuses on doctors visits, simple access to prescriptions and requisitions, and is free in covered provinces. A unique feature is you are able to choose your doctor from their listing.
  • Cover Health– Another virtual “walk in clinic” this platform is free in Ontario under OHIP and offers same day appointments, 7 days per week.

Virtual Mental Health Platforms

Accessing quality mental health services is difficult, and a significant barrier for many people is simply leaving the house. Accessing support through easy to navigate virtual platforms can be life changing. While the cost of the programs can be notable (the per-visit cost can be similar to an in-person session with a credentialed therapist), this can typically qualify under Extended Health paramedical coverage or through a Health Spending Account.

Two notable mental health platforms are:

  • MindBeacon With a focus on mental health support, specifically, Cognitive Behavioural Therapy, MindBeacon is highly regarded in the virtual mental health support space. As the online practitioners are credentialed psychologists or social workers, fees can typically be submitted through benefit plans.
  • Inkblot Launched in 2018, Inkblot Therapy strives to alleviate the extremely long wait times that many people face in accessing mental health support. As a platform focused exclusively on mental health, Inkblot offers confidential virtual therapy, CBT, continuity of care, webinars and training, trauma and treatment services, chronic disease management, psychiatric consultations and collaborative care, work and life support

Virtual Health is here to Stay!

The pandemic provided the opportunity for expansion and innovation in the virtual health landscape. While there will always be the necessity for in-person medical treatment and virtual offerings should not be exclusively relied upon, they do solve numerous problems people face in accessing healthcare, and provide a comfortable and convenient alternative, where appropriate.

Whether you choose to implement an employer-sponsored paid program or not, employers should take the time to ensure employees are aware of the virtual health landscape, and the options available to them. There are many educational materials available that can be distributed to employees to assist in spreading the word.

Please feel free to reach out if you’d like to learn more. We love to hear from you!

FAQ’s on Virtual Care

Can a virtual health care provider prescribe medication?

Yes, this is one of the core services, however they will not prescribe controlled or addictive substances.

Can I see a specialist through a virtual care provider?

Sometimes, yes but more commonly you must still be referred to a specialist by a regular GP. Under some paid programs, specialists can be accessed.

Can I access virtual care if I’m not in one of the provinces where it’s insured under provincial coverage?

Yes, the same service is available, but a per-visit cost is charged that starts around $30. Subscriptions to virtual care platforms are available as well.

Can I see my own doctor through virtual care?

It depends! If your doctor works for one of the providers, you may be able to see them through a virtual care platform. Or they may provide this through their clinic.

How do I connect with a virtual provider?

Typically, you will engage online through your computer, table or smartphone. Once booking an appointment, you can usually choose a phone call, text, live chat or video conferencing for the appointment.
telehealth plan insights by Immix Group

Key Takeaways

• Virtual health platforms today offer a convenient and effective solutions for many medical concerns.
• There are numerous free virtual health platforms available today.
• Paid options typically provide enhanced services, namely guaranteed quicker access.
• All Employers should promote virtual health care offerings to their employees, whether or not you provide an Employer-paid version.
Lindsay Byrka

Lindsay Byrka BA, BEd, CFP

Vice President, Immix Group: An Employee Benefits Company
A Suite 450 – 888 Dunsmuir St. Vancouver V6C 3K4
O 604-688-5262 E lindsay@immixgroup.ca
W www.immixgroup.ca

Top Benefits Conversations of 2022

It’s a wrap! As we begin the New Year with refreshed energy and excitement for what 2023 may bring, we wanted to share a recap of the key stories in benefits over 2022.


Extreme Difficulty in Hiring

The theme of our client meetings this year can be summed up in one simple sentence “Where did all the people go?” Businesses struggled to hire (and retain) qualified people. Employers told us they had candidates ‘ghosting’ interviews or simply not showing up to their first day, a trend that most had never previously experienced.

Time and again we were told by employers that they were desperately in need of staff, and that their existing team members were stretched too thin or in roles they were not hired or properly qualified to fill. The labour shortage is evident with a record-tight labour market, according Stats Canada: Labour shortage trends in Canada (statcan.gc.ca).

“Salary and benefits” continue to top the list of most important job factors for employees. Providing and more importantly communicating and highlighting a competitive benefits offering will make you stand out.

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The Shift to Hybrid Work

There has been a massive shift in how we work over the past few years. Hybrid work, or working partly remote and partly in-office became the norm post-pandemic, with most employees reporting they prefer working from home.

This has had a big impact in terms of managing and hiring, measuring performance, and ensuring engagement. We wrote about hybrid work and posed the question: Is working from home an employee benefit in two parts. The basic takeaways are that remote work is here to stay, employees prefer a hybrid model, and a formalized WFH policy is a must. 


The Great Resignation, or rather, the Great Retirement

The much-discussed Great Resignation did not occur in Canada like it did in the US, but what Canada experienced is actually more concerning:  a record number of retirements.

A record 300K people retired in Canada in the 12 months up to July 2022 (up 30% from the same period the previous year). Early retirement, so those between age 55-65, made up almost half of the overall number of retirees. With our demographics here in Canada, it will only grow larger. With the most experienced people exiting the workforce, there is a real risk to businesses due to the lack of mentorship and transfer of knowledge for younger generations.

How does this tie into benefits? Offering those in the final stages of their career enhanced coverage and work flexibility are potential solutions to entice your most experienced people to stay a few additional years.


Continued Focus on Mental Health and Well-being

As we transitioned out of the pandemic, the focus on mental health remained at the forefront. Employers continued to ask for resources and coverage options to ensure their staff had access to the mental health support they required.  

Far beyond the EAP or the dollars available for counselling visits, employers sought various ideas to support mental health including: return to work plans, 4-day work weeks, assisting employees with financial concerns through financial literacy and group savings plans and other programs designed to provide the flexibility needed to better support individuals and families and remove barriers to care.

More than one third of all 2022 Long Term Disability claims are mental health related. Claims for mental health are up 75% from 2019, and experts anticipate this will rise in 2023.


High Inflation

A key conversation in 2022 was the inflation we saw across the board; this was especially noticed with the cost of groceries. After years of low interest rates, Canada experienced eight interest rate adjustments in 2022. For many people, this directly impacted their borrowing costs, affecting both personal and business expenses and decisions.

2022 saw increases to the Dental fee guides far higher than historical averages. Unfortunately, it appears that the Dental Fee Guide increases for 2023 will once again be much higher than usual, with 8.5% for Ontario and 9.8% for Quebec already reported. With costs for practitioners and other insured expenses also rising, we anticipate larger than typical increases to claims across plans.


Federal Dental Plan

The Federal Dental Plan was rolled out the end of 2022. Employers had many questions on this program, wondering the impact to their Employer-sponsored insured dental plans. Generally speaking, there is little or no impact on existing plans, due to the qualification parameters for the new Federal plan.

The program provides coverage for children under 12 only. In order to qualify for any level of coverage, family income must be under $90K, and the children must not have access to private dental coverage (i.e. Employer plans). The government states that this is the first stage in developing a more comprehensive federal dental plan; only time will tell!


Change to EI Sickness Benefits

Effective for December 18th, 2022, the Federal Government announced a change to EI Sickness benefits, extending the duration of pay from 15 weeks to 26 weeks. Employers had many questions about this and the impact on their insured Long Term Disability programs which typically begin at week 17, at the expiration of EI Sickness payments.

In short, Employers are not required to adjust their LTD plans. Generally speaking, it is not in the best interest of those who are insured under LTD plans to remain on EI Sickness rather than transitioning to LTD. 

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Flexibility in Benefits

Finishing up the list, an underlying theme to benefits conversations in 2022 was the desire for flexibility and customization. As we know, one size does not fit all when it comes to benefit plans, which these days must include elements of flexibility to ensure everyone’s needs are met. We saw employers embracing customized work arrangements including hybrid work models and four-day work weeks.

From a product standpoint, the Immix Group set up more Health & Wellness Spending Accounts than ever before as Employers sought a simple way to provide spending flexibility to their team.

As always, we are happy to discuss your program with you!

Please reach out to us to discuss how we can help with your program; we love to hear from you.


Read more:


Labour Shortage Stats Can:








Hybrid Work:









8 Reasons for Increases to your Employee Benefit Plan Premiums    – Latest News from Immix Group


Mental Health:

More than a third of disability claims in 2022 due to mental-health reasons: survey | Benefits Canada.com

Mental health claims soar by 75 per cent | Canadian HR Reporter




Flexibility in Benefits:

One size fits all? Not when it comes to employee benefits. – Latest News from Immix Group

Lindsay Byrka

Lindsay Byrka BA, BEd, CFP

Vice President, Immix Group: An Employee Benefits Company
A Suite 450 – 888 Dunsmuir St. Vancouver V6C 3K4
O 604-688-5262 E lindsay@immixgroup.ca
W www.immixgroup.ca

8 Reasons for Increases to your Employee Benefit Plan Premiums   

Pondering the question: “Why do my benefit plan costs keep going up?” We’ve got answers.

If you’ve walked away from your renewal meeting scratching your head at the rate adjustment, you’re unfortunately not alone. Many advisors don’t do a great job explaining a rate change, and the math used by insurers can be quite (unnecessarily!) complicated. Our goal with this article is to give you insight into what causes rates to increase or decrease, and hopefully help you to better understand your program and what you can do to achieve cost sustainability.

Renewal rate reductions DO happen! We promise.

Before we get into why rates increase, we’d like to point out that for many of our clients, they see their rates reduce from time to time! Approximately 30-40% of our clients in a given year experience an overall rate decrease, rather than an increase.

We conducted a quick review of our block of business, and for their 2022 renewal rates:

  • 43% of our clients saw a reduction to their Extended Health Care rates
  • 30% of our clients saw a reduction to the Dental Care rates
  • 75% of our clients saw their pooled rates held without change

It’s a fact! Employee benefit program rates do not always increase, even in times of high inflation.

We want our clients to understand how benefit plan pricing works

During a renewal meeting, one of our primary goals is to ensure that our client understands WHY rates adjust. One of our key values at Immix is transparency; showing the details of the claims experience and how the rates are calculated is important to us.

First, as your advisor, we are responsible for determining fair pricing is presented to you for the year ahead. On a typical non-refund insured program, this means assessing the claims experience and projecting the required premiums for the upcoming renewal year, using some basic mathematical formulas. We look closely at the composition of the claims, the inflationary trends applied, the IBNR (Incurred But Not Reported) factors etc., but once we are satisfied we have arrived at fair pricing, our goal is to ensure you also understand.

However, if you’ve walked away from a meeting with your benefits advisor and you’re googling to attempt to understand why your pricing has increased, here are some insights:

1. Your claims experience is high.
This is the obvious one! In short, what was paid out in claims was too high relative to the premiums you paid for the benefit. This applies to health, dental, and to an extent, short term disability.

In very simple terms, if you paid $100 in premiums, and the claims paid back to members were $125, you have a Paid Loss Ratio of 125%. If you paid $100 in premiums, and the claims paid back were $50, you have a Paid Loss Ratio of 50%. While other factors come into play some of which are described below, in short, the premiums need to be sufficient to cover the claims, at a certain break-even mark.  

2. Your group is not fully credible/ has low credibility.
What is credibility? The simple explanation is that it’s the portion of your own claims experience used in the renewal rate calculation, versus the percentage that is based on the insurer’s block of business or manual rates. This is expressed as a percentage.

With Credibility of 25%, this means that 75% of the experience used to calculate your rate adjustment is based on the insurers block of business or manual rates, not your own claims experience. This can have the effect of helping or hurting your renewal rate calculation, depending on whether your claims experience is better than or worse than the insurer’s.

Credibility is based on the size of the group and the number of years with the insurer. The larger and longer you are with a carrier, the higher the credibility. It’s worth noting that within Immix Group’s broker-managed pools, we have full credibility for all groups, from day one.

More Reasons for Increases to your Employee Benefit Plan Premiums

3,Inflationary trends come into play.
Benefit programs are not immune to basic inflation, and an inflationary factor is incorporated into rate calculations.

Firstly, inflation affects claim costs, including fees charged by benefit providers such as paramedical practitioners, medical supply offices and dental clinics. In particular, we saw a huge increase to the 2022 Dental Fee Guide in BC, at 7.35%. With inflation hitting everything right now from groceries to gas to wages, you can also expect to see claims dollars increasing, across the board.

When calculating the renewal rates, the anticipated higher cost of future claims is taken into account.

An inflationary trend* is typically applied to the paid claims (along with the change in IBNR reserve) to arrive at the Incurred Claims, the number that is used in the calculation to project the required premium for the year ahead. Although the term “Incurred Claims” is a bit confusing, it’s basically your claims, trended for inflation and reserve adjustments.

4.You have a low Target Loss Ratio.

This might be based on the size of your group, how long you’ve been with the carrier, or perhaps you are inside of a pool. Nevertheless, this directly affects your renewal rate calculation under a typical insured plan.

If you’re not familiar with this term (read more here), Target Loss Ratio refers to the ‘break-even’ mark for the experience-rated benefits (typically health and dental, and partially, short-term disability). The Target Loss Ratio is the goal as far as where the Incurred Loss Ratio will fall, for the plan to not lose money. Assume the following:

  • 75% Incurred Loss Ratio, and 72% Target Loss Ratio
    • 75/72= 1.0417 (a 4.17% rate increase applied)
  • 75% Incurred Loss Ratio, and 84% Target Loss Ratio
    • 75/84= 0.8929 (a -10.71% rate decrease applied).

As illustrated, Target Loss Ratio is a key factor in your renewal pricing calculation. It’s a reflection of the costs to run the plan and includes the payment to the advisor.

5.You’re inside a pool where the experience of the pool drives your pricing.

Perhaps you had very low EHC claims, but the rates are still going up 15%, because under the pool model you are in, everyone in the pool gets the same adjustment based on the overall experience of the pool. Fair? Not at all. However, that’s how many pools are managed.

Even worse (in our opinion!) if you’re inside a pool where you are not allowed to see a breakdown of the types of claims or even the claims dollars compared to the premiums, you have no way of knowing if your pricing is fair. While it’s a lot easier for the advisor and insurer to give everyone the same rate adjustment, in addition to unfairly punishing groups with low claims experience, it doesn’t provide the transparency needed to properly manage the program.

6.You have aging demographics or a generally ‘older’ group.

We have discussed mostly the factors that affect health and dental pricing, but the pooled benefits (Life, AD&D, Dependent Life, Disability, Critical Illness) are also subject to rate changes. These are primarily driven by shifts in the overall group of people with regards to the headcount, male vs female split and the distribution over age brackets. As a group becomes “older” or there are higher concentrations of people in the older age brackets, rates tend to increase for pooled benefits.

A higher percentage of males vs females will drive life insurance rates up, whereas the opposite is true for disability pricing; proportionately more females drives the disability pricing up. This is simply a reflection of mortality and morbidity tables (likelihood of death or disability, respectively).

For the health and dental, an “older” group also will impact claims. Older groups are more likely to claim for prescription drugs, and often the more costly and ongoing drugs associated with chronic conditions. When it comes to Dental, older people are also more likely to be claiming for more expensive procedures such as crowns, bridges and dentures as opposed to just regular cleanings.  

Other Reasons for Increases to your Employee Benefit Plan Premiums

7.Your plan was set up with manual pricing.

Perhaps you are setting up group benefits for the first time meaning there is no claims history for your group of employees. The pricing that is implemented when a group is first established is based primarily on the demographics of the group, in combination with the selected plan design (known as book rates, or manual rates). As there is no information as to the medical or dental needs of the group, the pricing is really just an estimate based on data held by the insurance carrier. After the expiration of the initial rate guarantee period (15-24 months, or even longer for some benefits), the rates will be adjusted based on the factors described above for a typical non-refund insured plan. What may happen is that claims are far higher than estimated, meaning a rate increase is required. Alternatively, you could see your rates drop.

8.Your plan was set up with discounted pricing when you moved carriers.

Perhaps you decided to switch insurance carriers due to the reduced pricing presented to you. If it was not carefully analyzed and explained, you may be surprised to see a large increase at the first renewal with the new carrier. One reason for this is to recoup the sales discounts that were applied to entice you to make a move.  As we have written about, sometimes a discount is warranted (i.e. in assessing the claims ratios, the rates were too high) and sometimes they are illogical (the premiums proposed are far less than the historical claims). It is when the proposed rates seem far too low, where one needs to be cautious.

These discounts can be significant; insurers can offer 15%, 20% even beyond 30% discounts to obtain business, along with lengthy rate guarantees. As moving a group can be onerous, they anticipate they will likely retain the business for at least a few years, so will have the opportunity to increase the rates and recoup any sales discounts.


The answer? There are a lot of reasons for pricing to go up, but also reasons it can reduce.


As you can see, there are a variety of reasons why benefit plan pricing changes, whether it relates to your people, your pricing model, the broker and/or insurer you’ve engaged, or quite simply factors going on in the world. Working with an experienced and qualified employee benefits consultant is essential in ensuring your program remains sustainable for your organization.  

*Inflation: This is often expressed with a time lag factored in, so the number you see is higher than the annual expected inflation. For example, if the inflationary trend is displayed as 14%, this is divided by 12 and spread over the full year plus the additional months to the point the rates will change. Therefore, 14% over 16 months is actually 14/16×12= 10.5% inflation.


Not always. For fully-insured non-refund plans, rates can increase or decrease depending on the claims experience of the group or shifts in the demographics.

The credibility of a group refers to the portion of the groups own experience that is included in the renewal rate calculation.  

This refers to the ‘break-even’ mark for the program, or the projected point of profit vs loss for the experience-rated benefits, for the insurance carrier.

The ratio of paid claims, trended and with reserve adjustments factored into the premiums, expressed as a percentage.

The ratio of the paid claims to the premiums, expressed as a percentage. 

These are the ‘book rates’, or the rates used by an insurance company based on the demographic composition of the insured group, in combination with the plan design.

Lindsay Byrka

Lindsay Byrka BA, BEd, CFP

Vice President, Immix Group: An Employee Benefits Company
A Suite 450 – 888 Dunsmuir St. Vancouver V6C 3K4
O 604-688-5262 E lindsay@immixgroup.ca
W www.immixgroup.ca

One size fits all? Not when it comes to employee benefits.

Yes, it’s possible to gain the pricing advantage found within a benefits pool while also having control over your plan design!

When we begin discussing the strategy that Immix has created when it comes to group benefit plans one of the first questions we are asked is whether belonging to a benefits pool means having to implement a specific benefits plan design for your company. The short answer? Absolutely not! We know that one size does not fit all. The needs and wants of an organization when it comes to benefits vary dramatically, and our role includes not only ensuring you’re able to implement exactly what you want, it’s helping you to design the right program.



Standard plan designs don’t make sense- because every business is different.

Businesses view their benefit plans differently, and the structure and offerings of the programs reflect this. There is no real ‘right or wrong’ but there is effective and ineffective at reaching your desired outcomes.

Ensuring your benefits plan fits into your overall compensation model, matches your business’ philosophy and values, and does what it’s intended to do is not simple! This is where experienced advisors play a huge role. We know the market, we know how to design cost effective strategies, and we can help you achieve your goals.



But you know your people best

You probably have a good gut instinct as to the needs of the people that comprise your organization, especially if you’re a smaller team. You likely have demographic data on the age and sex breakdown of your group as well. But the key word here is ‘people’! It’s easy to get caught up in making assumptions based on the demographic profile of an organization.

And yes, there are many generations in the workplace today and there are certain characteristics we tend to assign to different generations. Generations in the workplace is one thing, but people are still people. Just because you’re 25, doesn’t mean you don’t have a chronic illness.  And just because you’re 65, doesn’t mean you don’t want a wellness spending account to cover your gym memberships and supplements.

While we tend to focus on age groups when we’re discussing benefits, we want to acknowledge that as individuals, we have vastly different needs, regardless of where we fall in the generational tagging system. There are also geographic and industry differences that affect what the benefits plan offering should look like. Understanding exactly who your people are is the key to designing just the right program.


A little data goes a long way

Knowing your people is one thing, but translating this into the correct scope for your benefits offering is something else. This is where the team at Immix Group comes in; you might need our help to survey your staff, to analyze your historical claims experience, or to walk you through programs and services that may be new to you. If you’re like a lot of employers, you might be seeking to add flexibility and choice to your benefits offering. The good news is that this is now easy to achieve!

beyond traditional health benefits

Because the right program makes a difference

The phrase ‘recruit and retain’ gets tossed around a lot when it comes to discussing the purpose of a great benefits plan. To break it down, you want the right benefits to help keep your best people. Salary compensation is important too, but what your organization brings to the table that adds to the total compensation package could be enough of a difference-maker to keep your best staff over the long term. The same applies when you’re recruiting; recruiting is challenging, and more and more people are asking up front about benefits offerings.  

Benefits beyond a traditional health and dental plan

A shift we have seen is towards asking about non-traditional benefits (so beyond the typical health insurance/ dental plan). Potential hires are asking about things such as health spending accounts, wellness/lifestyle spending accounts, group savings plans or a virtual care/mental health support program (or all of this!). People want the details on paid parental leave and paid time off, which goes hand in hand with the focus on work-life balance, and organizational flexibility as a whole.
employee benefits life balance

We designed our pools with flexibility and customization in mind

 One of the key benefits of how we have structured our broker-managed pools is that they actually have the reverse effect of a typical pool; we are able to provide MORE flexibility, including a choice from multiple major carriers.

Because we are working with our insurance carrier partners in a unique way, we are not always subject to the typical constraints imposed by underwriters for small groups (limits on life insurance, limits on dental coverage for new groups, limits on paramedical amounts). Our partners consider you part of our overall block of business, rather than treating you as a stand-alone company. While you’ll always be able to see your own claims experience and dollars in and out of the plan, being viewed as part of the Immix ‘block’ behind the scenes provides you with more than just pricing advantages.


Benefit plans must be cost effective

Even a fully customized, flexible benefits plan can be cost effective. The pricing model we’ve created at Immix is ideal for achieving the balance between customization and the low admin fees associated with inclusion in a pricing pool. Because we are negotiating the overall admin costs with the insurance provider on behalf of a large number of businesses, we’re able to pass the savings along to you, and spend the time needed to get the plan right- rather than haggling over pricing with the insurer on a group-by-group basis.


Not all pools are created alike

We understand that when you hear the term ‘pool’ you may jump to the conclusion that your business will be forced to implement a standard plan design or choose from a few plan options. Or, that you won’t be able to see any of the claims experience for your group. While other benefit pool offerings do take this approach, this is simply not the case with the Immix Pools.

Customization does not need to be expensive or complicated. Offering benefits that meet the needs of your employees regardless of age, sex, health or other identifying criteria can be done, and on your budget.

That’s why our model is so effective; low administrative costs, total customization and transparency, and experienced advisors who can work with you in a dedicated way to get it right.

Please reach out to us to discuss how we can help with your program; we love to hear from you.

Lindsay Byrka

Lindsay Byrka BA, BEd, CFP

Vice President, Immix Group: An Employee Benefits Company
A Suite 450 – 888 Dunsmuir St. Vancouver V6C 3K4
O 604-688-5262 E lindsay@immixgroup.ca
W www.immixgroup.ca

Check to Ensure your Benefits Quote is Actually for a Comparable Plan

5 Key Areas to Check to Ensure your Benefits Quote is Actually for a Comparable Plan

Inflation is on everyone’s mind; wherever you look, prices are rising. Unfortunately, benefit plans are not exempt from this. When the cost of dentist visits, medical items and procedures goes up, the result is often higher claims. This can sometimes end up passed along to employers as a renewal rate increase. 

Many of you may be considering getting a quote on your benefits plan or may have already received quotes from alternative providers.  Before you make a decision on moving your program, there are a few key points to check to ensure your quote is not too good to be true.

Is it truly apples-to apples?

Consider this scenario: you’ve been presented with a quote for a benefits plan. You had asked for the quote to be apples-to-apples to your current plan. The good news is the price is significantly cheaper than what you’re paying, and supposedly, the plan designs are equal. But are they?

In our line of work, it’s not uncommon to come across what is positioned as a comparable plan, only to find there are many details that have resulted in the lower price. They can be glossed over in a plan summary, and when the time is not taken to examine every nuance to the coverage, it can leave owners- and their employees- disappointed. There is nothing worse than rolling out a new program only to hear from an employee that their prescription -which was always covered under the old plan- is now excluded.

As we have written about in the past, it’s very common to get discounted pricing from an insurer. In short, the carriers usually need to extend some level of reduced pricing in order to gain your business.

And certainly, there are opportunities for true savings on administration costs.  But discounts aside, and beyond the summary of the coverage, we have compiled a list of specific plan elements to check and compare. 


Top 5 things to Review if a Benefits Quote seems Too Good to be True


  1. Review the details of the Prescription Drug Plan:

What are the details of the drug plan? Is there a managed drug formulary, excluded drug categories or drug caps? Does the plan mandate generic substitution or not?

A drug formulary is simply a list of the drugs that are covered on the plan. Oftentimes, a drug formulary is designed to exclude certain medication categories (fertility drugs or oral contraceptives are typical examples), in order to cut costs. In some instances, a drug plan may even exclude specialty drugs, the expensive but often lifesaving/ lifestyle saving drugs. While it’s often positioned as a benefit to employers, this could leave your employees with major uncovered drug expenses.

It is important to understand the implications of the drug plan. Generally speaking, a drug plan is a key part of the extended healthcare and is intended be an insurance plan. A plan that covers antibiotics (roughly $10-15) but excludes drugs for MS or Chrohn’s disease ($10K+ per year) is not providing coverage against a financially significant, often unexpected expense. While it’s true that a more open drug plan could mean higher drug claims than under a more restricted, managed formulary, the program’s stop-loss max will typically work to limit the plans exposure to high-cost drugs.

How the program adjudicates brand name versus generic drugs should also be clearly known; it’s standard these days to have generic substitution on a program, but this can work differently depending on the carrier or how the plan is set up (for example, will the plan allow the doctor to indicate ‘no substitution’ and therefore cover the brand name version of a drug?). Differences in this area have cost implications.

Lastly, is the annual limit for prescription drugs ‘unlimited’ or is there a dollar limit? You may be okay with implementing a capped drug plan, but again, you need to understand the details and implications. A qualified and experienced benefits advisor will be knowledgeable on all the above points, and most importantly, should be open and transparent about what you are getting.

Reviewing the health benefits plan
  1. Check the Dollar Maximums and Limits for Key Items:

You may have checked in the plan summary that the coinsurance is the same; 80% on certain lines of coverage, 100% on others. But what are the per item or category maximums?


The following are the most common items where benefit maximums may be listed, in the fine print:

      • per visit limit for paramedical services, such as $10 or $25 per visit reimbursement, rather than up to the practitioners reasonable and customary limits (i.e. $100 for massage visit)
      • annual per person dental limits in dollars; is this per level of coverage, or combined?
      • dental procedure limits such as scaling units
      • dental recall limits; is it the standard 6 months or has it been pushed to 9 months or even 12?   
      • eye exam limits; is it set to “reasonable & customary” meaning it will adjust with inflation, or is it a set amount? Is the amount reasonable given the cost in your area?
      • Orthotics, surgical stockings and other medical items
      • and as mentioned, is there an annual drug maximum, vs an ‘unlimited’ drug plan


While item reimbursement limits are standard practice, they do vary by carrier and many can be customized in a quote. It is important to understand how this may compare to your current plan, and whether the limits are reasonable, given the overall cost of the item, and the intent of your program.



  1. Check the Contract Wording and Coverage Details of the Disability Insurance


We say it all the time: long term disability coverage is the most important but often the most overlooked part of a benefits plan. This is an area to pay close attention to; in the event of a claim, how the claim is handled depends on the contract that is in place which could greatly impact the plan member, potentially for decades. Things to watch for:

      • What is the definition of disability, in words? How does this compare to your current plan?
      • Are commissions, bonuses and overtime pay or T5 earnings properly addressed? If the contract covers salary only, and this is a small percentage of total compensation for certain people, that could leave them grossly underinsured.
      • Cost of Living Adjustment; is there a COLA clause, or an inflationary adjustment included for the benefits payments? Is this important to you?
      • Is the program set up as taxable or non-taxable (is the employer or the employee paying the premiums?)
      • Is the duration of disability benefits to age 65? While this is the norm, we are seeing a trend towards a 5 or even 2 year benefit duration, to reduce costs. If someone goes on disability, they could be disabled for the duration of their life; an insurance plan that only pays them for a few years may not meet your requirements as an employer.


There is no bigger waste of money and potential liability than a disability plan that fails to cover people adequately and accurately; reviewing this area with an expert is crucial.

Reviewing details of a health benefits quote
  1. Check the Termination Ages: How long can people remain on various parts of the plan?

Different benefit lines typically have age-based termination or reduction schedules. For example, many life insurance benefits reduce the coverage by 50% at age 65, and then terminate completely at age 70 or 75. For health and dental, coverage is often in place right to age 75 or even ‘retirement’, meaning there is no actual termination age so long as someone is still actively at work.

We have noticed a trend towards lowering termination age and have seen coverage ending at 65 or even 60! For many employers, this is a big deal and it’s often not highlighted in a summary of benefits as a deviation. It is a good idea to additionally check the travel coverage and ensure this part of the extended health care is retained in alignment with the EHC, if possible.      

  1. Review the Mechanics of the Pricing:

Many people fail to review how the quoted premiums compare to the historical claims, or to do a basic ‘reality check’ on a too-good-to-be-true quote. On a typical experience-rated program, the premiums must be adequate to pay the claims, with the other pricing factors such as inflation, IBNR and target loss ratio taken into account.

Some questions to ask are: What is the actual discount that the carrier is investing? What is the duration of the rate guarantee?  What will be the process (financially speaking) when the plan is renewed? What is the Target Loss Ratio? If the plan is to be part of a pool, how does it work? Many times, you can find this out and often the carrier will be transparent as to how they plan to recoup any losses. A qualified benefits advisor should be able to explain this in detail and understand exactly what the renewal process will look like with a specific provider.  


Some plan design differences may be acceptable to you

There are always going to be nuances to carriers that are unique to them, and where they simply won’t directly align with your existing plan. Sometimes this means a slight improvement, and sometimes this could be perceived as a takeaway. At the end of the day, what’s important is that you understand the small deviations and that you are not buying something under misleading or mistaken circumstances.

An experience and qualified benefits advisor will do a detailed analysis

With the help of an experienced benefits advisor who knows the terminology and nuances to a quote and contract, the details can be understood. You may review any differences and be totally fine with the program not providing the same level of coverage. The key is to be aware, understand any implications, make an informed decision, and communicate any changes to your staff.

At the Immix Group, our benefits experts can help you obtain a quote, understand the quote and what it means for the future, and manage not only the onboarding of your new program, but the ongoing plan management. 

As always, feel free to reach out to us. We love to hear from you!  

Lindsay Byrka

Lindsay Byrka BA, BEd, CFP

Vice President, Immix Group: An Employee Benefits Company
A Suite 450 – 888 Dunsmuir St. Vancouver V6C 3K4
O 604-688-5262 E lindsay@immixgroup.ca
W www.immixgroup.ca


Part 2: The Hybrid Work Model: Is working from home an “employee benefit?

In the first part of this two-part article on the hybrid work model, we discussed remote work from a productivity perspective. For the most part, the numerous studies that are coming out are stating that productivity is either unaffected or increased, and this is especially true for knowledge workers.
In addition, most employees prefer working from home, or at least having this option part of the time. We will now take a closer look from an HR perspective as to why maintaining or implementing a permanent hybrid work model may be the smartest choice for your organization. We will seek to answer:


What do employees want? Do they prefer a Hybrid Work Model?

Yes, the stats are clear. The majority of employees want the option to work remotely, at least part of the time, and they feel very strongly about this! Some survey results show:

  • 76% said support for flexible work post-pandemic is important to them
  • 62% want to work from home at least 40% of the time
  • 30% want to work remote at least 3 days per week.
  • 27% of Canadian office workers would prefer to be fully remote

In fact, just 12% said that working entirely from the physical workplace would be most ideal. While many employees missed the social connections and other benefits of being in the workplace, the benefits of hybrid work far outweigh the in-office advantages.
As quoted in the HR Reporter

It’s clear that the role that the physical office plays in the day-to-day work and satisfaction of employees has changed dramatically during the pandemic. We’re not going back to how things were before, and businesses need to adjust to the many operational realities that come with that,” says Nick Georgijev, country manager for Amazon Business Canada.

Why do employees prefer remote work? What does remote work offer?

Turns out that positive workplace culture is much more than ping pong tables and endless snacks, which don’t actually provide employees with key things they really want to feel valued, which include flexibility, work-life well-being and autonomy. Among other benefits, working from home at least part of the time offers:

  • Reduced costs in commuting; transit and vehicle maintenance
  • Time gains, including from lack of commute 
  • Location flexibility, such as the ability to live in a lower cost area
  • Flexible working hours
  • Customizable office spaces and the comforts of home
  • Mental health benefits and general improved well-being
  • Increased productivity for many
  • Overall healthier people, according to studies on long-term hybrid workers


To expand on a few of these points, for many, the ability to work from home is a key part of improved work-life well-being. Flexibility as to where one works can be an integral piece in achieving a balance that minimizes work related stress while optimizing health and general well-being.

For example, for those with young kids, working from home instead of commuting to a physical workplace can mean many extra hours spent with young children, per day. It can mean easily integrating simple household tasks, rather than being absent from the home for eight or ten hours or more.

Many of the benefits are both financial and reduce stress: reduced or no commute, less time and money spent on office apparel and physical appearance, and the potentially most significant, housing. When it comes to housing, being able to work remotely could mean the ability to live in a lower cost region, rather than near the major city centre where the office is located.  In fact, 48% of those who moved since the pandemic began, factored remote work into their decision.

Hybrid Work Choice

How can the Hybrid Work Model be an advantage for Employers?


Many of the advantages that may be seen as beneficial to employees are equally beneficial to employers. Implementing the ability to work remotely, offers employers:

Notably, when employers can recruit from a wider, more diverse group of people due to location flexibility, there is the potential to attract more and better candidates, including those who desire a hybrid work model due to their unique circumstances. And of course, it works both ways: Just as a broader talent pool benefits you as an employer, employees have opportunities that are not limited or defined by geography.

Remote work also appears to increase employee retention: “72% of employers say remote work has a high impact on employee retention—employees are sticking with their employer when they have remote work options.”



How are employers viewing the movement towards hybrid or even fully remote work?

According to a BDC study, 74% of SME owners say they will offer their employees the opportunity to continue to work remotely. This varies between organizations and person to person, but generally, employers appear to be understanding the dual benefits to offering a hybrid work model.  



Will offering a Hybrid Work arrangement help me in recruiting great employees?

Yes. Job seekers are asking for work location flexibility at an increasing rate and many are completely unwilling to take jobs where at least some remote work is not a possibility. Today, to be competitive, offering hybrid work is becoming more and more essential.

According to the BDC, 54% of employee say “access to remote work will be a determining factor” in both applying for or taking a job. When Arianna Huffington posted a poll to Linked In February 2022, asking ‘if you were to look for a new job, what’s most essential to you’? the results confirmed people have balance in mind. “Being able to work from home” got 34% of the vote, with 40% going to “Better life-work integration,” These two go hand-in-hand, one could argue.  

hybridwork April3

Will my employees leave if I don’t allow for a Hybrid Work Model?

For many, it’s a dealmaker/ dealbreaker. When surveyed, employees indicate they would consider leaving their job if they were forced to return full time to the office.

  • 43% are likely to look for a new job if their employer mandates a return to the office full time.
  • Almost 50% of Gen Z and Millennials would consider quitting if their employer didn’t offer remote work.

While it may seem extreme, the reality is that employees have many options now. With so many having been given the opportunity to experience working from home due to the pandemic, they are not willing to turn back.  

“Companies that refuse to support a remote workforce risk losing their best people and turning away tomorrow’s top talent.”- Stephane Kasriel, CEO of Upwork

With more and more progressive employers embracing the mindset that ‘it doesn’t matter where or how you work, just that the job gets done,’ why wouldn’t employees seek out these roles, given the majority of our workforce is telling us they want this?

Hybrid Work

How do Employers implement a formalized Hybrid Work model?

If you’re like many employers, prior to the pandemic, you may have had few or no employees working remotely, so never required a remote work policy.

The challenge? Determining how to integrate this work model in a more formalized way. If you’re like the majority of employers, you may lack a strategy.  As with any employee benefit, your approach needs to consider the values of your organization, the purpose of the benefit, in addition to the actual details of the new structure.  Consider:

  • Roles; which roles can be done fully remotely, versus those that require a worksite presence?
  • Put it in writing; details your expectations and employee responsibilities and revise employment contracts where applicable.
  • Structure; How many days in vs out? Is it a set policy? Is it different for different people/ different roles?
  • Personal circumstances; what works for one employee may be different from another and considering personal circumstances show employees you value them as individuals.
  • Support and Supplies; What will you provide employees to support their work from home? Tech equipment, supplies? Ensuring smooth tech is key to success.
  • Virtual check-in’s. How many are needed, and what are the requirements? Camera on or off?
  • Rethink your Key Performance Indicators; what was measured in the past may shift in a hybrid work model.
  • Management; ensure equal time for those in-office and those working remotely, and ensure communications and decisions do not favour one employee type over the other
  • In-person events and meetings; occasions to bring people together in person are valuable and a great opportunity to team build and improve morale.

There are many factors to consider, and like all employer decisions, taking the time to think through all the pieces is important. The impact of decisions surrounding WFH can be significant and deserve proper attention.

Is providing the option to work from home an ‘employee benefit’?

I would argue that this falls solidly under ‘total compensation.’ The flexibility to work from home is invaluable to so many people, and could be the difference in securing amazing team members. There is value in offering workplace flexibility, and it’s no surprise this is showing up as a key feature in many job postings.

hybridwork April5

Empower your employees: the smart choice to optimize productivity

At the end of the day, if you’re hiring good people that you trust, and the job is getting done, why not empower employees to make the choice as to the best place for them to be most productive? Trust goes a long way, in fact, according to the Harvard Business Review, employees in “high-trust companies” report

  • 74% less stress
  • 106% more energy
  • 50% higher productivity
  • 13% fewer sick days
  • 76% more engagement
  • 29% more satisfaction with their lives
  • 40% less burnout.

Adopting a hybrid work model shows you trust employees to get their work done effectively and on time, even when you can’t physically look over their shoulder. While it means making changes to how you manage and measure work, ultimately, it’s a work model that is here to stay and offers numerous benefits for everyone. However, like any employer decision, it’s best to formalize your expectations when it comes to working under a hybrid model.

Looking for assistance in developing your own employee benefits program and policies? We love to hear from you!



Courtney, Emily.  The Benefits of Working From Home: Why the Pandemic isn’t the only Reason to Work Remotely. (Flex jobs).  https://www.flexjobs.com/blog/post/benefits-of-remote-work/

BDC.(June 15, 2021). Remote work is here to stay: BDC study. BDC. https://www.bdc.ca/en/about/mediaroom/news-releases/remote-work-here-stay-bdc-study

Birkinshaw, Julian, Cohen, Jordan, Stach, Pawel. (August 31 2020). Research: Knowledge Workers Are More Productive from Home. Harvard Business Review. https://hbr.org/2020/08/research-knowledge-workers-are-more-productive-from-home

Munro, Matt. (May 31, 2021). How Working from Home Increases Productivity. WBM Technologies.https://www.wbm.ca/blog/article/how-working-from-home-increases-productivity-infographic/

Kelly, Jack. (March 16th, 2022). Hybrid Will Be The New Work Style, But 72% Of Businesses Lack A Strategy, AT&T’s ‘Future Of Work’ Study Shows. Forbes.com. https://www.forbes.com/sites/jackkelly/2022/03/16/hybrid-will-be-the-new-work-style-but-72-of-businesses-lack-a-strategy-atts-future-of-work-study-shows/?sh=1c351e083989

Staff. (April 7, 2021). 90% of Canadian remote workers say working from home hasn’t hurt productivity: survey. Benefits Canada. https://www.benefitscanada.com/news/bencan/90-of-canadian-remote-workers-say-working-from-at-home-hasnt-hurt-productivity-survey/

Staff. (2022). Key Benefits of the Hybrid Work Model for Employers and Small Businesses. Rocketlawyer.https://www.rocketlawyer.com/business-and-contracts/employers-and-hr/company-policies/legal-guide/key-benefits-of-the-hybrid-work-model-for-employers-and-small-businesses

Staff. (October 4th, 2021). Majority of Canadians want to continue working remotely post-pandemic: survey. Benefits Canada. https://www.benefitscanada.com/news/bencan/majority-of-canadian-workers-want-to-continue-working-remotely-post-pandemic-survey/

Lindsay Byrka

Lindsay Byrka BA, BEd, CFP

Vice President, Immix Group: An Employee Benefits Company
A Suite 450 – 888 Dunsmuir St. Vancouver V6C 3K4
O 604-688-5262 E lindsay@immixgroup.ca
W www.immixgroup.ca


The Hybrid Work Model: Is working from home an “employee benefit”?

At the peak of the pandemic, estimates were that over 40% over people were working from home. As we transition out of the pandemic many are now embracing remote work in a new way, even when given the option to return to the workplace.

But will it stay this way? Is remote work a good thing, for employers and employees?


Everyone is talking about the Hybrid Work Model

We continue to see a steady stream of news articles on working from home, positing whether or not this is good for business, and of course, whether this is something that will continue to be prevalent in a post-pandemic world. These articles have varied in their stance; some state employers should be ordering employees back to the workplace, with others describing the notable benefits that have come from the pandemic-induced work-from-home situation. Others have discussed the inequalities; for example, the idea that working from home would set women back in the workplace, as they are more likely to choose this situation, and that they will therefore be negatively impacted with lost opportunities compared to their in-office counterparts. On the flip side, there are an equal number of articles describing the positive benefits for women, especially mothers of young children.


Different businesses require a different approach

Of course, whether a hybrid work model is beneficial is industry specific. Not everyone who was forced to work remotely-or still finds themselves working remotely- feels this is the optimal model (teachers, for example!). And certain home situations or lack of resources may mean remote work is not ideal.

But where it’s a possibility, it’s worth exploring the pros and cons as you work to develop your own long-term plan when it comes to your group of employees


Hybrid work: employee productivity plus recruitment and retention factors

Our two-part blog will discuss the Hybrid Work model, focusing on Employee Productivity and Recruitment & Retention factors. We will answer some key questions you may have as an employer or manager, including:

  • What is a hybrid work model?
  • Are my employees as productive at home?
  • Why do employees want to work remotely?
  • Should I let my employees work from home?
  • What is reasonable for remote vs. workplace balance?
  • Does supporting remote work help attract and retain good employees?
  • What are the financial implications of remote work?
  • How do I implement a work-from-home policy?
  • How do I optimize a hybrid work model?

As an employer, you may find yourself pondering the tough decision on whether to allow employees to continue to work from home, and what this might look like. In the tough hiring environment we are now in, you may even feel like the choice is not yours.


Just like your benefits plan, your approach to WFH needs to be customized to your business

Our goal is to help you make the best decision for your company. As always, we know that every business is unique and what works well for one, is not ideal for another. Hopefully, with the various pros and cons in mind, you can implement the best decision for your company.

Hybrid Work

The Hybrid Work Model is here to stay

Prior to the pandemic, about 5% of Canadians did the majority of their work from home. At the peak of lockdown, estimates are that up to 42% of workers were remote. As restrictions have eased and we’ve become vaccinated, remote workers have reduced to around 25-30%.

The expectation is that by 2025, there will be an 87% increase from the pre-pandemic levels. Studies are telling us that working from home is here to stay.

A hybrid work model (a flexible work model that combines working from the workplace and working remotely) has numerous benefits. It’s these benefits that are leading progressive employers to embrace this model of work, rather than sticking to a more traditional site-based work environment.

Of course, managers and business owners wonder if this is beneficial to the bottom line of the company.


Are my employees actually working from home? Are they being productive?

Depending on the business, productivity is measured in different ways. And of course, whether at home or the office, it’s affected by various factors. We say we want to increase productivity, but what does that even mean?

Productivity is basically the amount of work done in a unit of time, or the measure of performance or output.


These questions have crossed the minds of most business owners and managers. The short answer is that the research tells us not only are employees working, for the majority, they are more productive. Here is what some studies are telling us:

Depending on the study, the numbers vary. But what appears consistent is that there is not a drop in productivity overall, and for certain types of workers, productivity is higher when given the opportunity to work from home.

“We think, mistakenly, that success is the result of the amount of time we put in at work, instead of the quality of time we put in.”


A hybrid work model allows for ‘knowledge workers’ to more effectively prioritize

Everyone is different in terms of when and how we’re most productive; some of us are night owls, and some of us do our best work early in the day. Choosing when and how we get our work done has proven to increase productivity. According to the Harvard Business Review study:

“Researchers studied knowledge workers in 2013 and again during the 2020 pandemic lockdown and found significant changes in how they are working. They learned that lockdown helps people focus on the tasks that really matter …during lockdown, people viewed their work as more worthwhile. The number of tasks rated as tiresome dropped from 27% to 12%, and the number we could readily offload to others dropped from 41% to 27%.”

For knowledge workers, or those where “effectiveness is determined by the use of brainpower and their capacity to make sound judgments” a hybrid work model is especially empowering and conducive to increased productivity.


Working from home can actually mean fewer distractions

We joke that ‘this could have been an email’ when it comes to meetings, but it’s often no joke! The workplace, while offering undeniable social and collaborative benefits, also comes with distractions and time drains. Unnecessary or overly lengthy meetings and socializing take time away from work, while commuting consumes not only time but energy that could be focused on work.


But aren’t we losing the collective power of the group, when it comes to brainstorming and creative collaboration?

This is a valid concern for employers, and one of the potential negative aspects of remote working. In addition to managing people remotely and a loss of the social ties that in-person work brings, a decrease in collaboration is the biggest concern for most employers. So what’s the optimal solution? Like everything in life, balance is key. What appears to be the best model is a hybrid arrangement, whereby employees have a balance of on-site and remote work, and the ability to make the choice that works best for them as individuals, within reasonable boundaries. 


While this is not the right choice for every employer, for many, particularly those with ‘knowledge workers’- supporting a hybrid work model is the smart choice.

A hybrid work model benefits both employers and employees. And, as you’ll see in Part 2 of this blog series, the majority of employees want the option to work remotely. In Part 2 we will delve into the hybrid work model from the employee perspective; why they value this arrangement so highly and the specific benefits. We will take a closer look from an HR perspective as to why it helps to recruit and keep great employees, and why maintaining or implementing a permanent hybrid work model may be the smartest choice for your organization. And lastly, we will outline several tips for employers in developing a customized hybrid work model.

As always, please feel free to reach out to us to discuss your employee benefits program. We love to hear from you!


Trichur, Rita. (September 1 2021). Hybrid work risks becoming the next ‘career killer’ for women. Globe and Mail. https://www.theglobeandmail.com/business/article-hybrid-work-risks-becoming-the-next-career-killer-for-women/

Birkinshaw, Julian, Cohen, Jordan, Stach, Pawel. (August 31 2020). Research: Knowledge Workers Are More Productive from Home. Harvard Business Review. https://hbr.org/2020/08/research-knowledge-workers-are-more-productive-from-home

Staff. (April 7, 2021). 90% of Canadian remote workers say working from home hasn’t hurt productivity: survey. Benefits Canada. https://www.benefitscanada.com/news/bencan/90-of-canadian-remote-workers-say-working-from-at-home-hasnt-hurt-productivity-survey/

Travers, Sarah. (June 2021). How Hybrid Work Can Help Working Moms- And Your Company . Forbes. https://www.forbes.com/sites/forbesbusinesscouncil/2021/06/18/how-hybrid-work-can-help-working-moms—and-your-company/?sh=31babab25e71

Lindsay Byrka

Lindsay Byrka BA, BEd, CFP

Vice President, Immix Group: An Employee Benefits Company
A Suite 450 – 888 Dunsmuir St. Vancouver V6C 3K4
O 604-688-5262 E lindsay@immixgroup.ca
W www.immixgroup.ca

Add to your Recruitment and Retention Toolkit with a Group Savings Plan

Group Savings Plan

Are you having a hard time finding and keeping great people? Don’t overlook the power of enhancing your benefits offering with a simple yet effective retention tool: a company savings plan.

We are hearing from clients and peers that hiring and keeping great people is more difficult right now than anyone can remember. It’s being called the Great Resignationis it impacting your business as well?  


Why are people leaving their jobs? What is causing them to choose different opportunities?

Certainly, the pandemic has impacted how people feel about their jobs, their time, and exactly how they want their work life to look and feel. People have experienced a resetting of priorities, and a taste of a different way of working. But does the employee benefits plan offering still matter? Yes, absolutely!


What do employees want in their benefits offering?

From our perspective as benefits advisors, we know that great benefits go a long way. People expect a comprehensive benefits plan, and these days they want flexibility and choice to be part of the offering. More than ever, people want work-from-home flexibility if the job allows for it, autonomy over their day, and competitive pay. Culture matters, and great leadership from authentic, supportive and caring people. A recent article showed these top 3 factors driving employee retention:  

  • Benefits (34%)
  • Strong Sense of Culture (31%)
  • Belief in Senior Leadership (29%)

To us, these three items are intrinsically linked!  Great leadership understands that you need to empower people and meet their needs; doing so results in a positive and engaged culture. But how do you meet needs? A great benefits plan can play a big role.


But what about a company Group Savings Plan?

Because it’s RRSP season, and the ads are everywhere due to of the looming March 1st deadline, it’s timely to point out that employers should be using this simple and easy tool to enhance their benefits offering.  If you’re paying competitive compensation and have a good health and dental plan in place, then a retirement savings plan is a natural next step.


Is it a Pension, a Group RRSP, or the Company Retirement Plan?

Whether you call it an employer retirement plan, a company RRSP, a group savings plan, or the ‘pension plan’, an employer-sponsored Group Savings Plan is a highly valued part of a benefits program. In fact, when asked, employees say that their benefits are more important to them than an equivalent amount in straight pay.

The exact type of plan that’s right for your group depends on your organizational needs and goals. There are many products available that can be employer-sponsored as part of a “Group Savings Plan”:

  • Registered Pension Plans (RPPs)
  • Registered Retirement Savings Plans (RRPSs)
  • Deferred Profit Sharing Plans (DPSPs)
  • Tax-Free Savings Accounts (TFSAs)

Which type of plan is right for you? While most employers choose a RRSP or RRSP-DPSP combo these days, there is still a place for pensions, depending on the goals of the business. Working with a qualified advisor, and walking through all the relevant considerations, will help you decide on the right plan for your team.


A Group Savings Plan is truly easy to set up and administer.

What most employers and HR personnel may not realize, is that there is no cost to setting up a workplace employee savings plan, other than what you may decide to contribute on behalf of the company. And guess what? There are no rules when it comes to employer contributions; employers can contribute a fixed percentage, a certain dollar amount per person or not at all. The choice is yours.

What are the advantages for employees in participating in a Workplace Savings Plan?

If it's not in the budget to have an employer contribution right off the bat, a plan can still provide great value for employees. A Group RRSP, for example, provides employees:

  • Systematic savings
  • Pre-tax investment contributions, meaning reduced income taxes
  • Tax-deferred growth of investments
  • Lower investing costs than comparable retail plans

What are the advantages for employers in sponsoring a Group Retirement Savings Plan?

  • Contributions are tax-deductible for employers for certain plans
  • Inexpensive way to provide additional employee benefits
  • Shows employees you are invested in their well-being
  • Attract great people and reward key employees

Group Savings Plan


The mental health connection: help employees to reduce stress with a Group Savings Plan.

Employees rank ‘finances’ as their number one cause of stress. As we wrote in an article last year, helping employees to save for their futures in a direct way can assist them in taking control of their finances.

Going a step further, the implementation of an employer-sponsored Group Savings Plan provides the opportunity to offer employees financial literacy education. When you work with the Immix Group, we not only ensure Education sessions are made available to everyone in a variety of formats, we also ensure that all employees have access to qualified financial advisors.


A Group Savings Plan may be just what your company needs to stand out in the current hiring climate.

Why not find out more? Please feel free to reach out to us to discuss the best options for your company. We love to hear from you.


Further Reading

Benefits Canada Healthcare Survey 2021

HR Reporter The Ones Left Behind in the Great Resignation

The Right Time to Implement an Employee Group Savings Plan- Why and How

How to Design the Best Group Savings Plan for your Company

Harvard Business Review: Who is Driving the Great Resignation

Benefits Canada: Benefits tops list of retention tools for employers: survey

Employee Benefits vs a Straight Salary Raise: One is Significantly Better for your Business

Lindsay Byrka

Lindsay Byrka BA, BEd, CFP

Vice President, Immix Group: An Employee Benefits Company
A Suite 450 – 888 Dunsmuir St. Vancouver V6C 3K4
O 604-688-5262 E lindsay@immixgroup.ca
W www.immixgroup.ca

3 Action Steps Employers Can Take to Reduce Employee Financial Stress and Increase Financial Literacy

By Lindsay Byrka | BA, BEd, CFP
Vice President, Immix Group: An Employee Benefits Company


How can you assist your employees in achieving financial wellbeing?

November is Financial Literacy Month in Canada, and one of the key themes for 2021 is the importance of building financial resilience in challenging times.

When it comes to promoting employee wellbeing, we often think of health and dental benefit programs, offerings related to health and fitness, or certain elements of corporate culture. What we might not initially consider to be part of employee wellbeing is Financial Wellbeing. However, as one study after another shows us, money is the primary source of stress for most people. The 2021 Benefits Canada Healthcare Survey confirmed this once again, with 36% of respondents listing ‘finances’ as their primary source of stress.

So, we know that our teams are worrying about money.  But how can you, as an employer, help to reduce employee stress over money matters? Can you play a role in promoting financial wellbeing?


What does Financial Wellbeing mean and how do you know if you have achieved this?

The theme for Canada’s financial literacy month this year is building financial resiliency, which essentially means the ability to withstand unexpected or difficult financial situations.

“Financial well-being describes a condition wherein a person can fully meet current and ongoing financial obligations, can feel secure in their financial future, and is able to make choices that allow them to enjoy life. It’s determined by the extent to which people feel that they:


    •  Have control over day-to-day, month-to-month finances
    •  Have the capacity to absorb a financial shock
    •  Are on track to meet his or her financial goals
    •  Have the financial freedom to make the choices that allow one to enjoy life”


Consumer Financial Protection Bureau

Most people would agree that not worrying about money or their financial futures would help ease a lot of stress. Employers can certainly play a role, which starts with a commitment to employees to address this major source of stress.


reducing employee financial stress


Steps Employers can take to help employees achieve Financial Wellbeing

You may think the obvious answer is ‘pay employees higher wages’ but there are steps beyond this sentiment. In addition to paying competitive wages (which certainly matters!) employers should consider providing employees with two things: direct access to savings plans and financial education opportunities.


Group Savings Programs provide your employees the opportunity to save for the future

At the Immix Group, we believe that all employees deserve to have Group Savings programs included as part of their comprehensive benefits offering. These are very easy to set up, are low maintenance to administer, and additionally, they can be very low cost.

A Group Savings plan could be as simple as allowing employees to directly save into a RRSP or TFSA from their paycheque; there is no requirement to provide an Employer match. However, assisting employees in saving for the future by providing an Employer deposit is a major advantage. Because you can make changes to a Group Savings Plan easily and at any time, you can always revisit the amount of funds you are providing. Your deposits provide tax advantages to both the employee and the business, so it really makes sense to funnel money in this direction, as a form of increased compensation, rather than a straight pay raise.

As an added bonus, offering a group Savings Plan is a key tool in recruiting and keeping the best employees. It’s a win-win.


How can I help my Employees to improve their financial literacy?

Firstly, financial literacy simply refers to one’s “ability to understand and effectively use various financial skills, including personal financial management, budgeting, and investing.” Unfortunately, many people never receive education in these matters, despite how crucial they are to success, and ultimately, financial wellbeing.
Partnering with experts and offering employees financial education in a range of areas should be part of your comprehensive benefits offering. At the Immix Group, we have access to a whole team of licensed professional advisors, who understand the challenges that employees face, and can provide simple and tangible solutions and action steps. Advisors are even able to work one-on-one with employees and help them to develop their own financial plans.


reducing employee financial stress


Once is not enough; employee education needs to be ongoing

As part of Immix Group’s 7-Step Process we ensure education is available to employees on an ongoing basis. In addition to providing in-person or online education sessions, we have plenty of resources available to help employees in managing their financial lives.


Why should Employers worry about Employee Financial Wellbeing?

If your goal as an organization is to improve employee wellbeing, quite simply, you need to focus on the areas that are causing the most stress. We believe that taking some simple steps can be a big help to employees who are struggling to save, struggling to understand how to mange their finances and plan for the future, or who lack the basic financial literacy that is needed in our world.


To sum it up, the action steps Employers can take to help employee financial wellbeing:

  1. Ensure you are paying competitive wages for your industry and region
  2. Engage with a trusted benefits advisor to assist in designing and implementing a groups savings plan
  3. Work with your advisor to ensure employees are provided ongoing financial education opportunities, and one-on-one support

At the Immix Group, work with companies of all sizes to implement simple yet effective solutions when it comes to employee benefit programs, including employee group savings plans. If you would like to discuss ways to help improve your employees Financial Wellbeing, please reach out.

Any questions, please feel welcome to reach out to me at lindsay@immigroup.ca.

Disclaimer: All organizations and groups are different and applicable strategies should be reviewed with a licensed benefits advisor to review your situation.


For more articles, please visit our sister company Ciccone McKay Financial Group for a wealth of articles on budgeting, goal-based planning, navigating market turbulence, as well as a blog dedicated to financial literacy.


Ciccone-McKay Resources
Financial Planning Blog Articles: https://ciccone-mckay.com/blog.html
Financial Literacy: https://www.ciccone-mckay.com/financial-literacy.php
Market Commentary: https://www.ciccone-mckay.com/market-commentary.html

Sources and Resources


Lindsay Byrka

Lindsay Byrka BA, BEd, CFP

Vice President, Immix Group: An Employee Benefits Company
A Suite 450 – 888 Dunsmuir St. Vancouver V6C 3K4
O 604-688-5262 E lindsay@immixgroup.ca
W www.immixgroup.ca

Top 8 FAQs for Business Owners when Implementing an Employee Benefits Plan

By Howard Cheung, Account Executive, Immix Group: An Employee Benefits Company


1. How much does it cost to provide Employee Benefits?

Cost is often first thing that comes to mind when considering employee benefits. How much to budget, per employee, and what does this cover? Without an existing benefits program or past claims experience, insurers use “manual rates” which is pricing that factors in the demographic and occupational details of your group, for the requested coverage design(s), to provide your group with rates.

As for how much to budget, consider researching your sector’s benchmark salary and go from there to calculate a rough percentage. The % of total rewards cost (benefits is part of this) can range from 5% to 13% of payroll.

On the lower end, benefits could be under \$100 a month per employee, and on the higher end far upwards of \$1,000. It all depends on the details of your group and the plan you choose.


2. What do Employee Benefit plans typically cover?

Common coverage lines on benefit plans are:

  •  Basic life insurance
  •  Accidental death & dismemberment
  •  Long Term Disability
  •  Short Term Disability
  •  Critical Illness
  •  Health Care (drugs, paramedical, vision, travel)
  •  Dental Care
  •  Employee Assistance Programs (EAPs)
  •  Other common benefits include: Health Spending Accounts, Wellness Spending Accounts, Pensions, or Group Savings Plans.

Keep in mind that extended health care coverage (in particular, items covered under the Health Care portion of plans) is complementary to provincial healthcare (i.e. MSP in BC) and is not intended to replace or overlap.


3. When do employees receive benefits? Do they have to wait?

You can begin a new plan for existing employees at the first of any month. For new hires, most employers implement a waiting period of 3 months before benefits begin. You can customize this based on the needs of your business, but once determined, this needs to be followed unless a waiver is requested for an individual, or you change the waiting period for the whole program.

A “late applicant” situation occurs if a new employee is not enrolled in the program on time (after the waiting period). In this instance, the member may be required to go through underwriting and receive limited benefits.


4. Are part-time, temporary or hourly employees eligible to get employee benefits?

Standard employee benefit plans require a minimum of 20 working hours average per week in order to be eligible, plus completion of the waiting period. Employers may set their own minimum hours to determine who is eligible (eg. minimum 35 hours per week), and their own waiting periods.

Benefits classes may be used to set distinctive eligibility rules for different classes of employees (eg. management and other employees), and also to provide different coverage to different classifications of employees.


5. Will Employee Benefit plan premiums increase if my employees use the plan a lot?

New policies often have an initial rate guarantee period between 16 to 24 months for health & dental rates and even longer for pooled benefits (up to 48 months). After the initial period, most plans renew on an annual basis. The renewal pricing is generally based (at least in part) on assessing the claims of your group compared to the premiums you have paid. While a lot of factors come into play, there are many different ways that renewal pricing is determined and your premiums could either increase or reduce.

It is important to work with your advisor to thoroughly understand the pricing model recommended for your group, whether this is fully insured, refund account or ASO.  


6. Are Employee Benefit costs tax deductible?

Yes, employer-paid premiums for employee benefits are typically tax deductible to the corporation. In contrast, reimbursing an employee directly for medical expenses is not usually deductible, per CRA rules.

Whether a premium is paid by the employer or by the employee vis payroll deduction makes a difference with regards to taxation. To avoid taxable benefits for employees, some benefits should be employee-paid. 


7. What are the advantages for a company in providing a benefits plan? Does providing benefits improve morale? 

There are numerous reasons to provide a benefits program for your team:

  •  Is a tangible form of compensation to attract the best people and keep them.
  •  Health, Dental & EAP coverage helps improve health both proactively and reactively, reducing pain, stress & depression thereby increasing productivity
  •  Group retirement savings help reduce financial burden and stress
  •  Promoting and communicating about provided benefits is an additional channel to reinforce company culture and values.
  •  Studies show employees value benefits more highly than the equivalent in a pay raise


8. Should I shop around multiple places for benefit plans?

An independent benefits consulting firm can provide quotes from various suitable insurers. Insurers themselves are not typically equipped to provide consulting services and do not have access to the entire market.

In addition, once an insurer has been approached to provide a quote for a business, they cannot release another quote for the same business to a different benefits consultant. Only the benefits broker who is able to provide a current dated “agent of record” or “authorization” letter can work on your behalf to obtain quotes.

Given the industry rules outlined above, it is not efficient to utilize multiple brokers or to shop around. It is better to ask for a referral from a trusted peer or interview reputable benefit firms to find the right fit. Once you have decided with whom you want to work, it’s then time to have your trusted advisor look for quotes on your behalf.


About myself and Immix

I’ve been a licensed benefits consultant and broker for businesses in the Lower Mainland for 14 years. I work with the Immix Group team toward benefits solutions for organizations of varying sizes. We would be happy to help you, no matter what your organization’s size!


Any questions, please feel welcome to reach out to me at howard@immixgroup.ca.

Disclaimer: All organizations and groups are different and applicable strategies should be reviewed with a licensed benefits advisor to review your situation.

Howard 2

Hybrid Traditional + Flexible Employee Benefits: A Sample Design for SMBs

By Howard Cheung, Account Executive, Immix Group: An Employee Benefits Company


You are a small or mid-size business. You want affordable employee benefits with costs that you partially control – while having peace of mind that you can provide for unexpected health/drug claims. Read on! This article might just be the benefits blueprint you’re looking for.

In the 2020s, many businesses are being forced to adapt how they attract, hire and retain employees. Even for small businesses, it is not uncommon to have a five-generation age gap with significantly different health and wellness (a.k.a. personal) needs. The challenge: How to satisfy everyone, while keeping a sustainable budget and maintaining the ability to evolve as you free up cash flow and grow?

In this article, I illustrate a sample design that combines the best of two types of benefits:

  1. Traditional Insured Benefits: coverage for unexpected, catastrophic claims related to health
  2. Combined Health and Wellness Spending Accounts (CHWSA): cater to modern workforce needs (five-gen age gap) + budget customization.

Note that this is not the only way to design benefits to meet modern needs. There is no one-size-fits-all solution, as every group’s needs, budget and demographics are different.

Matthew Wong, CGA/CPA and Co-founder of Purpose CPA, gives a great high-level overview of the different types and lines of benefits available to SMBs. Matthew helps guide SMBs to navigate the accounting and tax nuances of the different types of benefits, as well as making sure you’re ready for future growth. Read more here:Employee Benefits for Small Businesses — (purposecpa.ca)


Traditional Insured Benefits (base plan)

A Traditional Insured Benefits program provides a set schedule of coverage for a set premium. Annual renewal adjustment is based on claims experience. Insured benefits have an important role in an overall comprehensive benefits plan because they include coverage for catastrophic claims, such as high-cost drugs and out-of-country claims. Including an insured program as the base layer can offerprotection for you and your employees from unforeseen, possibly devastating, health needs. Granted, for some SMBs with limited cash flow a fully insured health and dental program may be out of reach. Additionally, a traditional insured program does not include coverage for any personal/wellness-related expenses.

So, how to implement a benefits program that provides for unforeseen health claims and satisfies a wide variety of health/dental/wellness needs – all the while with limited cash flow? One way is to implement an insured program that provides a minimal amount of coverage for life and accidental death and dismemberment (AD&D), and basic health. The gaps can then be offset with a Combined Health and Wellness Spending Account (CHWSA).

The following three steps build a solid-but-basic insured health benefits plan:

  1. Secure the base-insured benefits program under a broker-managed pool for the most efficient use of your benefits dollar. See our article “Value of Broker-managed Benefits Pool for a sound long-term benefits strategy.
  2. Shift premiums around to minimize “money-in, money-out” type benefits. These are benefits that tend to have more predictable claiming patterns and, typically, a cap.
  3. Have 80% or lower co-insurance. This helps to reduce premiums while shifting a small amount of expense to the member.


Now to add the CHWSA!

A Combined Health and Wellness Spending Account provides employees with a pre-determined dollar amount of reimbursement for a wide range of expenses outside of their insured benefits, or beyond the plan maximums.

A CHWSA offers the element of flexibility, as each employee has control over how they allocate their funds between the two accounts, that is, Health Spending and Wellness Spending. As the employer, this is where you have the ability to control the cost and empower your employees to fit the plan to their needs.

The differences between the two accounts are:

Health Spending Accounts (HSA): an increasingly popular alternative or top-up to traditional health and dental plans. Only items considered an eligible medical expense by the Canada Revenue Agency (CRA) can be claimed through an HSA. Examples of eligible expenses are medical, dental, vision, diagnostic tests, lab scans and laser eye surgery.

Wellness Spending Accounts (WSA): extend coverage beyond the traditional type of expenses. Through a WSA, items such as work-from-home expenses, gym memberships, transit passes, yoga classes and even e-bikes can be covered. Employees may even choose to allocate the CHWSA dollars to a group savings program, e.g., Registered Retirement Savings Plan (RRSP) or Tax-Free Savings Account (TFSA).

This is how it works, along with a sample blueprint you can follow:


  1. Employer decides $X amount for the CHWSA
    • a) Optional: Set-up different eligible classes. For example, you may decide families get two times more the base amount. Or employees with two or more years of tenure also get two times more the base amount.
  2. At the beginning of each year (or at time of benefits eligibility), each member allocates $X into HSA and/ or WSA. This allocation is locked in until the next renewal period.
  3. Any health-related/CRA-eligible expenses paid out of pocket (e.g., expenses not covered under base-insured health, over-limit physio expenses, or dental or vision) may be claimed under the HSA. (See below for a sample list of CRA-eligible expenses.)
  4. Any other expenses not under CRA-eligible expenses paid out of pocket may be claimed under the WSA. (See below for a sample list WSA expenses.)
  5. Each time there is a claim/reimbursement, the employer will get an invoice of the claim + fee.
  6. Once the benefit year ends, employees may again change their allocation mix. Carrying forward any unused balance is optional (employer decides).
  7. Review your claim reports annually and see where the trends are for future tweaking and decision-making re benefits.
  8. No renewals (the only “renewal” is the reset of the benefits amount).




What to look for in a CHWSA platform?

Work with a benefits team who can set you up with a CHWSA platform, ideally a fully online digital platform, easy to manage, to maximize efficiency in admin/claims/processing. The platform would provide:

    1. Adjudication of claims to adhere to CRA guidelines and privacy of members
    2. Claims processing
    3. App or online claims
    4. Payments and reimbursement processing
    5. Live support
    6. Fees that range from 8-10% of claims
    7. Ideally, no setup or subscription costs or float requirements.


Eligibility guidelines

  1. Must be an incorporated active business with at least one employee. The business cannot only be generating passive income
  2. The benefit is available to all employees, not arbitrarily given
  3. Employees who are also shareholders must be collecting income.


So, what’s covered under a Health Spending Account (HSA)?



What’s covered under a Wellness Spending Account (WSA)?


As you can see, there are a lot of items wellness can cover. This is a comprehensive list that can be customized to better align with your business philosophy.


Tax considerations of allocated amounts to HSA vs. WSA

It is important to note that HSA and WSA benefits are taxed differently. The benefit dollars used up in a HSA are tax-free, whereas WSA dollars are taxable benefits. That is, if you claim $1,000 worth of childcare under your WSA, that will be counted as taxable income and you will get a tax slip. This is why there’s a lot of flexibility around WSA – and why we advise that you select wellness categories that align with your philosophy. Unused dollars do not have any tax impacts.


Organization growth and the importance of insured benefits

As alluded to earlier, insured benefits play an important role in having a solid benefits program. The importance of traditional insured benefits is to cover for the unknown, unexpected and high-cost:

  1. Sudden severe illness
  2. Accident
  3. Injury (rehab + drugs + loss of income)
  4. Pandemic-triggered expenses.


An actionable step right now: Do a benefit survey!

Whether you are applying the above or a different design, it would be wise to understand your own group’s needs by doing a benefit survey. Really quantify what matters to them. Aside from knowing what benefits matter, it may help form other areas of your culture. In knowing their personal needs – anonymously, of course — you can then better understand what type of benefits would work best.


About myself and Immix

I’ve been a licensed benefits consultant and broker for businesses in the Lower Mainland for 14 years. I work with the Immix Group team toward benefits solutions for organizations of varying sizes. We would be happy to help you, no matter what your organization’s size!


Any questions, please feel welcome to reach out to me at howard@immixgroup.ca.

Disclaimer: All organizations and groups are different and applicable strategies should be reviewed with a licensed benefits advisor to review your situation.

Howard 2

Renewing Employee Benefits in 2021? – Here are things to know going forward to keep costs down.

By Howard Cheung, Account Executive, Immix Group: An Employee Benefits Company


Due to the impacts of COVID-19 in 2020, many insurers provided benefits premium subsidies, or even deferred the program renewal date. In 2021, at least in insured benefit programs, renewals could look slightly different given the unique claims patterns we had in 2020. This is due to the temporary closure of health providers, the subsequent surge in services due to pent-up demand, derived extra cost due to PPE and business logistics, as well as increasing mental health issues and different working landscapes.

Whether you are a cost controller, work in human resources or a small business owner, there are some basic concepts of the renewal process that you should understand, to best deal with rate adjustments while keeping costs under control.


Why are renewal reports so complicated?

Renewal reports can be mind-bogglingly complicated. They don’t have to be. Yes, you have a great deal of data to consider in understanding your group’s claim usage. But there’s a key factor that defines your renewal adjustment.

This factor has to do with:

  1. target loss ratio, or TLR, and
  2. two formulas that will help you understand where your renewal should stand.

TLR, sometimes called a break-even ratio, is a percentage that represents the expense level of the insurance carrier. This expense level directly affects how much your group can claim before the insurance carrier loses money.

For example, let’s assume your plans TLR is 80%. First we need to calculate the loss ratio, which is claims paid/premiums paid. In this case, let’s assume claims paid were $90 and premiums paid were $100:

  1. loss ratio = total claims paid/total premium paid. Using the numbers above, this would yield a 90% loss ratio ($90/$100).
  2. estimated adjustment = loss ratio/target loss ratio. This would yield +12.5% (90%/80%).

There is a lot more that goes into calculating a renewal adjustment. For illustration purposes, we didn’t take into account a few other factors, such as credibility (how much of your group’s own claims are taken into account), trend (inflation factor) and reserves (claims lag).

But the above, in a nutshell, is a very basic description of how renewal rates are calculated. It’s a quick and easy way for a plan administrator to do the math to get a ballpark idea as to where the group should stand.


How is the TLR determined?

You might ask: How is the TLR determined? Usually, it’s determined at the time of inception and illustrated on the initial quote. Included in the TLR calculation are the insurance company’s costs in handling servicing and claims adjudication, as well as any commission paid to the broker. As the group size grows, typically the TLR will increase and the administration cost will be lower relative to the amount of premium the insurance carrier is receiving.

So, the lower the TLR, the greater the portion of your premium going into expenses and administration and commissions. On the other hand, the higher the TLR, the smaller the portion of the premium going to expenses and admin costs.

You want to ensure that your TLR is updated accordingly and is negotiated to be as high as possible. And you can do this by working with specialized employee benefits brokers that have preferred pooling arrangements.


Would you like us to review your benefits renewal and optimize your benefits dollars? Contact us for a free consult!

If you would like to have an in-depth discussion about understanding your renewals and unique strategies, please feel welcome to contact me howard@immixgroup.ca  with any questions.

Lindsay Byrka

Lindsay Byrka BA, BEd, CFP

Vice President, Immix Group: An Employee Benefits Company
A Suite 450 – 888 Dunsmuir St. Vancouver V6C 3K4
O 604-688-5262 E lindsay@immixgroup.ca
W www.immixgroup.ca

March is Fraud Prevention Month

By Lindsay Byrka | BA, BEd, CFP
Vice President, Immix Group: An Employee Benefits Company


Everyone has experienced that phone call, text or email making some claim that is inevitably aimed at getting you to click a link or provide information to give fraudsters access to your sensitive information. It’s rampant, and there are stories on the news every day about extremely crafty schemes that leave people defrauded, with less money in their bank account and often feeling embarrassed and angry that they fell into the trap.

Fraud hits every industry, and those out to defraud people go to great lengths to concoct sophisticated and effective ploys. While employee benefits program fraud doesn’t make the news as often as the distressing stories of seniors urgently buying gift cards, it’s also rampant and just as criminal an act.

In fact, CLHIA (Canadian Life and Health Insurance Association) states fraud to cost hundreds of millions of dollars per year in losses. Other organizations estimate the number to be in the billions of dollars. Sun Life Financial alone, used their advance anti-fraud tools to detect over $150M since their program launched in 2014. That is a LOT of money that could be going towards paying legitimate claims!


Fraud takes all forms

As we’ve written in the past , fraud takes all forms and it occurs at every level of the claiming chain. Plan members, plan administrators, and supplier offices -for example, your dental office- all participate in fraud, sometimes unknowingly!

Technology, while making it much easier to submit claims, also makes it much easier to submit fraudulent claims. Fortunately, it also makes it easier for insurance carriers to put in place systems to help prevent or detect fraud. Part of this process is de-listing service providers, which is essentially saying ‘we will not pay claims for items or services purchased through this particular provider.’


Why do some claim submissions have so many rules and requirements?

As a plan member or plan administrator, you may have come across seemingly arbitrary, finicky rules and regulations when it comes to claims submission requirements.

A common example is with claims for orthotics; when you are attempting to make an honest claim, it can sometimes feel like you have to jump through hoops (doctors note, a certain type of doctor only, pre-authorizations, and a certain method of submitting the claim). It can be very frustrating. It may feel like the insurance carrier implicitly distrusts you, when you’re just trying to be reimbursed for something that is legitimately and honestly required by you and covered under your insurance.

But these rules exist for a reason, and the main reason is fraud prevention, which also means cost containment.
When we advise plan administrators and members that the extra rules and procedures are to prevent fraudulent claims from sliding through, they’re often very surprised to learn that this is a very rampant and costly problem.

Countless times in explaining why the rules are in place, I have had members say “but I would never do that!” And it’s true, most people do not fraudulently claim under their benefits program.


Fraud can be subtle

Most people would not do something as obvious as creating a false receipt on their home computer. But fraud takes a more subtle form; a classic example is getting expensive sunglasses (without any prescription lens) and submitting them as an eye glass claim to obtain reimbursement. Vision Care providers can be complicit in this activity, providing receipts that falsely state the item purchased to be prescription eyewear.

Another example is submitting your receipt to more than one insurance carrier for reimbursement (for example, to your own plan, and to your spouse’s plan). There is a certain level of self-reporting and honesty that is required when someone is insured under two plans. While most people act honestly, and understand that they should only be reimbursed up to what they paid, others take advantage of the honour system that may be in place: this is fraud.


Why does this really matter? Don’t insurance carriers make huge profits?

Many people have the impression that insurance companies are making huge profits, and that the few hundred dollars they received for a not-fully-legitimate claim could not possibly have a financial impact. But the fact is that these dollars add up, and as we’ve stated, the amounts are staggering. While there is a certain segment that is conducted in a systemic way by organized groups, another segment is simply people acting as individuals.

But it does matter, and not just because it cuts into the insurance carrier profits. In actuality, for Canadian insurance carriers providing group benefits, the profits are typically quite small (as a percentage) on a benefits program. Often, just a small single digit of the premiums paid by the plan sponsor is actually profit.


But does it actually affect my specific benefit program?

For a typical small or midsize business, every year the insurance carrier compares the premiums that were paid to the claims that were paid back to the employees. The cost of the program for the year ahead is directly tied to this ratio.

If those claims are inflated even by a small percentage due to fraudulent claims, it can have a notable impact on the program’s renewal pricing.  In short, illegitimate claims take available money away from legitimate claims. When programs become more and more expensive, guess what tends to happen? Benefits are reduced or removed, to help control the cost.


Is this actually a big deal?

The CLHIA’s stance on this is ‘fraud=fraud.’ It is fraud, it is a crime, and there could be actual legal consequences to this action. There is excellent information through CLHIA’s Fraud=Fraud campaign. The site outlines what actions constitute fraud, the consequences, and what you can do. https://fraudisfraud.ca/

With previous cases of benefits fraud, including the Toronto Transit Commission case where Manulife was scammed for millions in false claims, people have been fired and criminally charged. In that specific case, over 200 employees were fired and 10 faced criminal charges.  

In a case of similar scale also in Toronto, 150 staff members either resigned or were fired due to their involvement in an approximately $4-5M benefits scam. In this instance, it was highly organized with the staff involved spanning multiple job categories.

In this case, one involved person stated to the press that they had been paying more into the plan than they were receiving in legitimate claims, so they therefore felt justified in their actions.  This is a common reason that is uncovered in these types of cases. However, like other benefits we gain in shared society (roads, schools, police, fire departments), some people benefit more than others in certain areas, and group healthcare is no different. Trying to make it ‘fair’ by defrauding your benefits program is a criminal act.


What you can do to help prevent fraud

Despite education of plan members, plan administrators, and sophisticated technology to detecting fraud, fraudsters persist. Here are a few quick tips on how to avoid and detect fraud:

  •  Check your claims history in your online portal or app; are all the claims yours?
    Ensure you are submitting to your own carrier first, then to your spouse’s plan (should you have both in place)
  •  If you receive the offer from a provider to provide you a receipt for something that is no
  • t what you actually purchased, you should decline (of course!) but also report the provider. Many carriers offer whistleblower lines to do so.
  •  If you learn of fraud through your own company, advise your HR department.

Lastly, if you’re a plan administrator and you suspect your program claims are not all legitimate, we can help you to review the claims. As benefits advisors, we have access to tools and resources that can help determine if claiming patterns are normal, or if something unusual is occurring.

As always, involving an experienced benefits advisor to review your program is the best way to ensure you are making the most of your benefits dollars

The experts at the Immix Group can be reached at 604-688-5559 or online at info@immixgroup.ca. Or reach out directly to Lindsay at lindsay@immigroup.ca

Lindsay Byrka

Lindsay Byrka BA, BEd, CFP

Vice President, Immix Group: An Employee Benefits Company
A Suite 450 – 888 Dunsmuir St. Vancouver V6C 3K4
O 604-688-5262 E lindsay@immixgroup.ca
W www.immixgroup.ca

The Best Time To Review Your Benefits Program Is Now!

By Lindsay Byrka | BA, BEd, CFP
Vice President, Immix Group: An Employee Benefits Company


2020 proved to be an unexpectedly tumultuous year for most people, and if you’re involved in running or making decisions for a business, you were probably taking a hard look at every aspect of your business. If reviewing your benefits program did not make the list, January is the perfect time to review your plan.


But how do you ‘review’ a benefits program?
One of things that make Immix Group stand out in contrast to other benefits consultants is our approach to reviewing an existing benefits program.

We don’t just put together a spreadsheet showing the pricing other providers would offer to gain your business. We go far deeper than that superficial approach, as we want to understand a lot more than the bottom line of a quote, and a lot more about your organization’s history, present state and anticipated future. Digging deep into your historical claims experience and pricing is key, plus we want to understand who you are, what you and your team want and need out of your benefits plan, how this compares to what you have, and what can be done to get you there! And of course, a priority is always creating the most cost-effective plan possible, without compromising on quality service, systems and coverage.

With the pandemic still very much a reality, and cost containment still a concern for most people, we wanted to revisit a blog we posted a year ago (before we knew what was coming!) which discusses the key items to consider when assessing the benefits program for your business.


Updated from January 2020

New Year, New Benefits?

At the start of a new year, we all make resolutions. After the uncertainty of 2020, you may be more motivated than ever to take a closer look at your benefits program.

When it comes to benefits, consider: Is this the year for minor benefits housekeeping or is your company due for a benefits overhaul?
Granted, every year should be the year for benefits housekeeping! That said, here is an outline of a few areas to review on an annual basis, and how to determine if your program requires more significant changes.
Hopefully, this will help you to decide just how much to address this year.


Keep things current
Before the year gets going full-steam, check that all your documents — hard copy and/or digital — are current. Ensure all forms, applications, benefits booklets and other items on file are the up-to-date versions. Toss or delete any old ones.


Personal details
Next, check that all employee data is up to date. Have your employees confirm personal details, including: their address on file, dependents, a change in single vs. family status, and their named beneficiary. Employees don’t always remember to keep you in the loop!


Access those tools
One of the silver linings of the pandemic is the speed with which our provider partners moved when it came to going digital with systems and services.

If your still employees aren’t using online and mobile applications to manage their benefits, the New Year is a logical time to send out instructions and encourage them to sign up. Some may be slightly less-than-savvy with technology; that’s understandable. But once they see the advantage of these fast, efficient tools, they’ll gladly adapt.


Pay attention to benefits lines where reductions/ terminations may apply
Check for any plan members who may be reaching the age where certain benefit lines may reduce or terminate. You will want to prepare to advise them of this, and ensure your billing accurately reflects the change when the time comes. For example, is anyone turning 65? Despite your best communication efforts, they may have missed that their long term disability coverage will likely be coming to an end.


Changes to laws or rules
Have any laws or rules changed that may impact your program? Are you compliant with any applicable collective bargaining agreements? If you’re even remotely concerned about this, drop everything and address it immediately. An experienced benefits consultant can assist you in understanding the fine print.


Employment contracts
Are your benefits accurately described in your employment contracts? Misrepresenting, omitting or including outdated items could become a problem for you in the future, such as in the event of a termination or disability situation. This is something to check every time you make a change to your program.


Plan for your benefits renewal 
Lastly, when is the plan’s renewal date? Based on this date, you’ll need to find out and prepare for:

  •  When  the renewal meeting will be held
  • What you would like to discuss this year
  •  When you will receive an update on the claims experience
  • Whether you need to pass new rates along to your payroll company; and,
  • What other dates are important in the year ahead from a benefits perspective?
Best Group Savings Plan

Basic administrative housekeeping for a benefits program is essential on a routine basis. But when is it time to take a deeper look at your plan, i.e., take a strategic-perspective view? If any of the following statements ring true, that time might just be now:


Think big-picture
You aren’t sure if your benefits plan takes into account your company philosophy with regard to health and wellness. Or, you have not yet developed a company philosophy!

When it comes to the benefits plan, what is your goal as a company? Have you defined a goal? Or are you somewhere between ‘bare minimum’ and ‘comprehensive and effective health and wellness offering’? If you haven’t taken the time to really think about this, it’s a worthwhile endeavor.

Your company may not have developed a philosophy and goal. But when it does, your benefits plan, like every other aspect of your organization, should be aligned.


Is your team happy with the program?
You haven’t recently surveyed your staff to assess whether the program is meeting their needs. You’re not really sure whether people are happy with the program, or what they may want to see changed. Or worse, you know they’re not happy!

If you haven’t checked on this lately (or ever!), it’s understandable. Other priorities come up, and another year goes by, with the same plan in place. But a new year is a good time to reassess. Consider surveying staff about whether the benefits program is still meeting their needs. They’ll appreciate the chance to let you know things they’d like changed. Again, this is worthwhile. As you know, a happy team is a team that stays. You want to be the company good people come to, not the one good people leave.


Get ahead of the game
At some point in your organization’s history, someone decided an employee benefits plan should be put in place, and hopefully, they were thoughtful in considering the scope and goals of the program. The question is, how long ago was this done? Has your organization changed, while the plan stayed the same?

When it comes to your plan design, coverage, carrier, or plan structure, you may be surprised to learn your program is totally outdated in certain areas and that change is required to bring you up to speed. This might be as simple as expanding the list of covered paramedical practitioners, or more significant, such as switching carriers to take advantage of innovations that were not available when the plan was first implemented.


The pandemic has brought mental health support programs to the forefront
Another way to think about this is the fact that the world has changed, and your benefits program may need to adapt to our new realities. Unfortunately, a major impact of the pandemic has been a reported decrease in mental well being and overall stress. Employees are seeking support, and today’s benefit programs, if they are to be truly effective, need to offer mental health support services.


What else is out there, in the world of benefits?
It is important to assess whether you are taking advantage of what the market has to offer, and weigh whether the current plan still makes sense. This is especially advisable if your plan hasn’t been thoroughly reviewed for a while by a benefits specialist.


A benefits expert — for the help you need
All this may sound overwhelming. If you don’t know where to begin, a benefits consultant can help. Benefits consultants can help take care of every aspect we’ve mentioned above — and more. We want to ensure as part of our process, we’re answering key questions, such as:


The challenges
Does the program take into account the challenges of your business, such as high employee turnover or low employee engagement? What’s next for your business and industry? We raise this point because it is important to consider the plan in terms of business growth and structure. It may be time to implement/abolish different classes of benefits, change waiting periods or eligibility criteria, or expand the group saving plan.

Who are you?
What are the areas that particularly affect or matter to your employee demographic? Are there specific health concerns within your employee population? When it comes to wellness, what are you already doing and could you be doing more?

Ultimately, a benefits plan should be dynamic, and provided the proper management and attention essential to ensuring you make the most of every dollar that goes into it.


Your benefits consultant should be a true partner to your organization
At the Immix Group, we always say we consider ourselves to be an extension of your HR department. That’s because we work with you in a meaningful, in-depth and results-oriented way. As benefits consultants, we’re here to help with everything from discussing your benefits philosophy to surveying your team; from analyzing your program to making recommendations and implementing changes.

Our job isn’t to simply process instructions from our clients; it’s to collaborate, bring our expertise to the table, and ultimately, to partner with you in ensuring you make the most of your benefits dollars. With all that 2020 brought, one thing you can do to make your life a bit easier is to engage a qualified benefits consultant. We’d love to hear from you!

The experts at the Immix Group can be reached at 604-688-5559 or online at info@immixgroup.ca. Or reach out directly to Lindsay at lindsay@immigroup.ca

Lindsay Byrka

Lindsay Byrka BA, BEd, CFP

Vice President, Immix Group: An Employee Benefits Company
A Suite 450 – 888 Dunsmuir St. Vancouver V6C 3K4
O 604-688-5262 E lindsay@immixgroup.ca
W www.immixgroup.ca

Employee benefits: What you need to know about discounted group benefits pricing

By Howard Cheung, Account Executive, Immix Group: An Employee Benefits Company


Howard 2

Business Owners: How to Design the Best Group Savings Plan for your Company


You’ve made the decision to implement a group savings plan for your team. You’ve worked it into the budget, and you know this is something you want to roll out sooner rather than later. Fantastic!
But what’s next?

What should you be considering to ensure the right plan for your group?

The good news is that as employee benefits consultants, designing, implementing and managing group savings plans is part of what we do. We can guide you through all the important considerations, and ensure you understand the options available to you. Most importantly, we’ll make it simple when it comes to implementing the plan and educating your team. Lastly, we make sure the plan continues to run smoothly and is kept up-to-date.

But first, when it comes to making sure you get it right, we have outlined the major considerations in putting together the right group savings plan.


Think it through: why are you doing this?

If you haven’t already, take a moment to stop and think as to the purpose of the plan. Is it just the next step in the development of a more comprehensive benefits offering? Are you trying to solve a specific challenge? Is it to replace a different compensation model?

The answers to these questions will inform how you structure the plan, because as with any benefits program, you have a lot of flexibility in how it is designed.


Should the plan offering be different, for different types of employees?

How does it fit into your overall company philosophy on benefits and compensation? Is everyone provided the exact same dollar amount of employer contribution, regardless of position or years of service? Or, is a model that provides increasing rewards over time more aligned with your philosophy? What are you doing in other areas of benefits? What is the demographic of your employees; what are their various needs and wants?


The right program should consider the characteristics that define your organization.

A group savings program, just like your group health benefits plan should be thoughtfully designed and implemented to ‘feel’ like your business.  It should be designed to provide solutions to the challenges your business faces, such a retaining skilled employees over the long-term, or attracting these people from other businesses.

These facts matter, and this should all be thoroughly discussed with your benefits consultants.


Structure of the plan

Pension, Registered Retirement Savings Plan, Tax Free Savings Account or Deferred Profit Sharing Plan? Where to begin? The good news is, we can walk you through the various pros and cons and differing features of the many types of groups savings programs.

All group savings plans are not taxed equally, and all program types do not provide the employer and employees the same features. For example, a Deferred Profit Sharing Plan (DPSP) allows for ‘vesting’ or rather, for employer contributions to remain under the ownership of the employer, until a certain time period has passed for the employee (up to 2 years). This can be a key feature of a program and can assist a business that is facing a challenge such as higher than desired turnover.

Pensions, in contrast to other programs, have a lot more rules attached to them and can be more complex to administer. But, based on your goals, this may still be the right choice.


Tax considerations matter too

Tax considerations are also paramount to the correct set-up of a group savings plan from both an employee and employer perspective. Contributions by an employer to a RRSP for an employee are a taxable benefit, whereas if these same employer contributions are made to a DPSP, they are tax deductible to the business, and not a taxable benefit to the employee. This is a major advantage and why many programs are set up as a RRSP-DPSP hybrid.  Getting the right program or combination of programs is essential in ensuring optimal tax efficiency.

group savings2


Select the right carrier for you

As employee benefits consultants, it’s our job to know what’s going on in the marketplace, and the various strengths and weaknesses of the various group savings plan providers.


Simple administration for both the employer and employee

The right carrier will ensure administration is seamless, integrates with your payroll system and provides both online and mobile options for employees. Is it important for you that employees can self-enroll online? This can be arranged.

For ongoing management, what is your preference for remittances? Most carriers offer many choices.


Current technology is key

These days, efficient, current and intuitive technology is absolutely essential and is typically near the top of the list of criteria in a recommended provider. Some carrier stand out in this area, while others have lagged behind, creating frustrations for plan sponsors and members. It is important to know who is getting it right and what they can offer.


But old-fashioned personal service matters just as much!

Prefer to talk to a real person? More traditional factors also matter such as local on-demand service support, call centre support and in-person education and training capabilities. Brand strength, organizational size and capabilities are also key considerations.
In understanding what matters most to your organization and team members, we can ensure the right fit.


Investment Menu Decisions

Regardless of the provider, a decision will need to be made as to the scope of the funds available. Is it important to you to have the largest selection of funds possible, or would you rather have a narrower range of choice? Providing choices does matter, but not so many to be confusing or overwhelming. We can help you to find the right balance for your group.

As the plan sponsor, you will also need to determine a default fund for those who opt out of making their own investment decisions.

Overall, the fund line up should provide access to the top brands, portfolio managers, and funds so employees will be comfortable investing. It is also important to include target date and target risk funds help make it simple for people to make investment decisions.

Another consideration is the inclusion of socially responsible funds; is this important to you or to your employees? This is a growing request and is certainly available through most providers.  

Luckily for Immix Group, our sister company Ciccone McKay Financial Group employs financial analysts that we engage to help in portfolio selection. This means ensuring your offering to your team meets every mark.


And finally, the cost considerations

group savings3

Low fees matter to everyone

Is it important to you that the plan is priced better than retail investing? It should be! These days, people are paying more attention to fees than ever before. The fees attached to the investment funds (the MERs, or management expense ratios) should be lower than retail for the same managed funds. One of the main purposes of a group savings program is to provide bulk buying power for this aspect of one’s financial life (investing) so providing competitive fees is key to ensuring participation in the program.

It’s worth noting that you should typically see few or no charges to the employer.


An Employer contribution

What’s in your budget when it comes to the employer contribution? While it’s technically optional, to make a plan really take off, an employer contribution is the cornerstone of a good plan. Even the smallest of employer contributions are ‘free money’ and extremely valued by employees. Somewhere in the neighbourhood of 3-6% of salary is a great starting point.

But, there are many different ways to structure the match, including a flat monthly or annual dollar amount. We can help you work out a structure that fits your budget. And remember- for most plans you can change this at any time.


Education for employees, from the right people

group savings4

So you’ve figure out all the details, and you’re ready to get things going. But there is one crucial aspect to work out: a great plan is not a great plan if you fail to effectively communicate with your employees!

 What’s the best way to relay important information to your staff? Is it an in-person session?  A live webinar? An emailed presentation?  What should be covered and in what level of detail?

It is critical to ensure employees receive basic financial literacy training, in addition to education specific to the parameters and operation of the plan. How can they make informed decisions if they have no idea what this stuff is all about? Our team understands how to communicate the details to your staff. Ensuring everyone gets the attention they need is our primary concern.

So, if you’ve made the decision to put in place a plan, it’s time to reach out! We’d love to hear from you to get started. The experts at the Immix Group can be reached at 604-688-5559 or online at info@immixgroup.ca. Or reach out directly to Lindsay at lindsay@immigroup.ca

Lindsay Byrka

Lindsay Byrka BA, BEd, CFP

Vice President, Immix Group: An Employee Benefits Company
A Suite 450 – 888 Dunsmuir St. Vancouver V6C 3K4
O 604-688-5262 E lindsay@immixgroup.ca
W www.immixgroup.ca

Business Owners: How to pivot your employee benefits to adapt to the changing landscape of employee needs

By Howard Cheung, Account Executive, Immix Group: An Employee Benefits Company


The year 2020 has certainly been a year of change. All aspects of life have adapted to a new normal, and this includes businesses and what it means to provide valuable benefits to employees. As business owners and managers of employee benefits, what can you do to continue providing high-value benefits to your employees, while maintaining your budget?


Traditional insured plans are simple, and the chosen structure for most SMEs

The majority of SMEs (5-99 employees) in Canada historically have traditional insured employee benefits programs. It’s quite simple; you pay premiums to an insurance company, and in turn, they cover employees for a set schedule of benefits. Premiums are adjusted annually, partly based on the spending patterns of the employees, relative to the premiums you have paid.


Studies show employers and employees both want flexibility

However, based on the latest 2020 Sanofi survey results, what many employees are missing in having only this type of benefit is flexibility and choice, something that caters to them as individuals. The overwhelming response from both employers/ plan sponsors and employees is the desire for some level of “Flex Plan.”

health spending accounts
health sponsors with a flex plan


The perfect addition to your insured program

Health care spending accounts or health spending accounts (aka HSAs) are the perfect solution to the desire for flexibility in a benefits offering.


A Health Spending Account works as follows:


Health Spending Accounts can cover both non-taxable and taxable items

HSAs are used to reimburse plan members for a very broad set of health and dental related purchases (eligible expenses are matched to the CRA list of eligible expenses, in a tax-free HSA). This list is far more expansive than what is typically covered under a regular insured benefits plan. Given a set dollar amount for the year, members choose when and how to use their allocation, depending on their own personal needs.

For programs that also allow for non-CRA eligible expenses (typically considered ‘Wellness’ expenses), items such as vitamins, gym memberships, fitness equipment, alternative practitioners and even childcare can be claimed. These items create a taxable benefit for the employee.

From the employer’s perspective, the key difference from traditional insured benefits is full control as to how much you want to spend. HSAs offers stability and flexibility, with no surprises. Probably the most under-utilized CRA- approved benefits offering, HSAs are cost effective and simple.


However, health spending accounts are not intended to replace insured benefits

Are HSAs the ultimate solution for benefits? No. HSAs provides flexibility and choice for a certain segment of expenses. Ultimately, there is very little or no insurance component which means members are not protected from long-term, significant health costs.

When it comes to long term protection such as for expenses associated with severe illnesses or catastrophic events, your health and dental benefits need an insurance component, where high expenses can be covered, without a dollar limit. This is where the traditional benefits serve as your foundational base. For example, a costly dental accident, a travel mishap or the diagnosis of a serious illness requiring lifelong medication; these all require traditional ‘insurance.’

As well, other coverages such as long term disability, life insurance or programs such as group savings plans, employee assistance plans or wellness and workplace culture programs are all valuable parts of a comprehensive benefits package, typically under an insured structure.


The role of a Health Spending Account

Health Spending Accounts are the perfect complement to your insured program and can often be carefully designed to replace certain items within an insured plan. HSAs are certainly a solution that is often overlooked, but that can provide a highly valued benefit that sets your company one level above the competition. Best of all? You control the cost.

ImmixGroup provides innovative customized benefits solutions. Feel free to reach out to me howard@immixgroup.ca if you would like to see how we can set your benefits apart from the competition!





Howard 2

The major impact of small businesses in Canada: Small Business, Benefits and COVID19

By Lindsay Byrka | BA, BEd, CFP
Vice President, Immix Group: An Employee Benefits Company


The major impact of small businesses in Canada: Small Business, Benefits and COVID19

At Immix, we have paid special attention to the especially precarious financial situation facing small businesses over the past 3 months. As employee benefits brokers, we have been helping our clients navigate their benefits and HR policies, with so many layoffs and work stoppages occurring. We have helped our clients to promote mental health and employee assistance programs, and of course, we have ensured all cost containment measures are taken.

But what else can we do? As our society gradually reopens in the wake of the COVID-19 pandemic, it is more important than ever to support local small businesses.


The impact of the lockdown on small businesses has been enormous

Even at the best of times, a small dip in revenue can mean the inability to pay bills or wages, especially for service businesses, with their extremely thin margins. The economic situation is obviously creating much worse than a small dip, with some industries completely closed for months on end. These small businesses may not survive, even as they are now granted permission to reopen.

Government programs have helped, but they do not replace the economic activity generated by an operating business. And unfortunately, many have been left out of these programs due to the qualifiers, or quite simply, it’s not even close to enough money to save their businesses.


Small and medium sized businesses in Canada (known as SMEs) are the backbone of the Canadian economy. Did you know:

  •  Of the approximately 1.2M employer businesses in Canada, about 98% are small businesses, under 2% are medium sized. This leave just a tiny fraction that are large employers.

  •  A small business is defined as having 1 to 99 paid employees

  •  A medium business has 100-499 paid employees.

  •  The majority (~54% of the total of 1.2M businesses) are micro-enterprises with just 1-4 employees.

  •  A total of 3 out of 4 Canadian businesses have 1-9 employees

  •  Small businesses employ 8.4M people, and medium sized businesses employ 2.4M people

  •  About 80% are in the services-producing sector.

  •  80% of people are employed in the private sector, with approximately 90% of those working for SMEs.

  •  Here in BC, this number is higher than the Canadian average, with over 93% of those employed int eh private sector working for SMEs.

  •  The contribution by SMEs to the GDP is around 50%.*


What does this tell us? SMEs play a crucial role in our economy!

The needs of small businesses are unique. As a small business ourselves, working primarily with other small businesses, we’re very familiar with not only the raw data above, we are familiar with the concerns and struggles of these businesses.

In our role as benefits consultants, we get to know our clients from both a financial perspective (the good and the bad they are experiencing), as well as from the human resource side (the struggles and victories associated with the ever-important human capital).


Our goal is to provide SMEs with innovative solutions

An area of challenge for many small businesses is employee benefit programs. As the numbers above show, most businesses are not giant corporations with specialized in-house experts. To bridge the gap, small businesses need to choose the right benefits partners, someone that will get to know the business and work out a custom solution that meets every need- financial and otherwise.  


Small Business and COVID19


Benefits that beat the competition

Like any businesses, the many small businesses with whom we work need to be competitive with other organizations when it comes to their health and wellness offerings. In fact, this is the number one concern that is raised when we are first meeting with a new client. They need to be able to attract the right people, and offer comprehensive benefits.

Often businesses think a great benefits plan is something they cannot afford if it is to be meaningful. Employers and employees alike often share the misconception that the benefits programs offered through the public sector or through massive corporations are superior and unattainable.

This is simply not true; affordable and effective solutions exist. We have been able to achieve this by the creation of unique, broker-manage pools (link to Immix pool blog).  It has been our experience that if there is a commitment to health and wellness, we are able to implement programs for these organizations that check every box.


Benefits and COVID19- what’s happening?

As we have navigated this pandemic and the associated shutdown of so many of our client’s businesses, we have seen the commitment to their employees reflected every step of the way. We’ve seen careful consideration of layoffs, extension of benefits during layoff, and a concern with mental and physical wellbeing and continued access to resources. We have helped our clients navigate their options and implement solutions.

Our insurance carrier partners have also stepped up, and premium relief measures were quickly introduced. Our strong relationships with our clients and suppliers has meant clear, quick and concise communication every step of the way.


Small businesses working with small businesses  

The pandemic has reaffirmed our decision to remain an independent firm, in a changing benefits landscape. We firmly believe that employee benefits programs are not a commodity; they require custom care and attention, and an engaged consultant that understands your business.

The landscape is changing, more over the last year than ever. Benefits consulting firms similar to ours have been part of an acquisition fever; large companies buying up other small, medium and large companies. For the Immix Group, despite the industry climate and opportunities, we feel staying independent is a major advantage. In short, it better aligns us with our clients.


When it comes to our small business community, the question we feel so heavily is ‘what can we do to help?’

The many articles on small businesses that you have likely been reading have a common thread: a plea for customers to continue buying from them. While we have no direct control over the re-opening of the economy, we can control our own personal spending and for some of us, our business spending.

So, at a personal level, buy from small businesses, when you can. Purchase a gift card now, to be used later. If you are a business, buy from and partner with other small businesses, when you can. As the stats show us, these are your neighbours, your friends and family, and most likely, your employer.  

We are all hopeful that businesses will be able reopen and thrive, even if under new rules and restrictions, but nevertheless, resume building, creating and providing valuable services.

If you would like to explore implementing a benefits program or reviewing your existing plan, we would love to help! Please contact us at 604-688-5559.  

* Government stats; latest data available is for 2018 https://www.ic.gc.ca/eic/site/061.nsf/eng/h_03114.html

Lindsay Byrka

Lindsay Byrka BA, BEd, CFP

Vice President, Immix Group: An Employee Benefits Company
A Suite 450 – 888 Dunsmuir St. Vancouver V6C 3K4
O 604-688-5262 E lindsay@immixgroup.ca
W www.immixgroup.ca

The value of employee benefits inside a broker-managed benefits pool, especially during times of uncertainty

By Lindsay Byrka | BA, BEd, CFP
Vice President, Immix Group: An Employee Benefits Company


If you are considering ‘taking your plan to market’ we want you to consider why our current climate is the time to join a benefits pool, transparently priced by a broker, rather than marketing direct with an insurance carrier.  

The COVID pandemic has altered the claiming patterns we are seeing.  This is the case right now and is what we anticipate continuing in the months to come. The impact on long term disability claims is a huge unknown, but the feeling is that there will be an increase in claims related to mental health. For reimbursement benefits such as dental and paramedical practitioners, it is difficult to predict if plan members will ‘make up’ the claims for services they could not obtain during the business closure period.



What we do know as benefits consultants is that our clients will not be at the mercy of the insurance carriers when it comes to pricing of their benefit program when they reach their first post-COVID renewal.

To back up and explain a bit further, employers enlist the services of group benefits advisors to recommend and assist in managing their benefits programs. There are exceptional benefits advisors in this city and country however there are unfortunately also benefits advisors who do not place the best interests of their clients first and foremost.

As group benefits consultants, one area of frustration is seeing the negative impact plan sponsors are exposed to when they were not properly educated on the pricing they were agreeing to when selecting an insurance provider. The ‘lowest bottom line’, without an explanation as to the discount level and future impact, is a misleading sales strategy that often leads plan sponsors to angrily look to ‘shop’ their plan after the first year. Many simply believed they were getting a ‘cheaper price’ because of the carrier.

The reality is the true cost of a benefits plan is extremely similar from carrier to carrier. A meaningful, and sustainable, differentiating factor comes with the unique arrangements the group benefits advisor has organized with the insurance carrier, on behalf of their clients.

Plan sponsors can often be lured by the promise of lower premiums, but oftentimes, they lack the understanding as to the true mechanics of the pricing, and in particular to the ‘investment’ the insurance carrier is willing to provide in order to obtain business.



We wanted to solve this problem, and we did

When it comes to group benefits programs, our approach at the Immix Group is focused on implementing broker-managed and priced benefit pools. We do not ‘shop the market’ and accept the highly discounted pricing that insurance carriers will put forth in order to obtain business. These prices are, in many cases, obviously unsustainable (for example, premiums 20% below the historical claims for a group). Unless you have compelling reasons to believe your claims will drop, when the plan renews, you will find that your claims were higher than your premiums, and a rate increase is in order.  

From the insurer perspective, they are willing to take an up-front loss, as they expect to recoup these losses over the next two-three years. When a plan sponsor has accepted pricing that was discounted, and therefore unsustainable, a rate hike at the first or second year renewal is a standard occurrence.



We decided as a firm to exit this game a very long time ago.

We have a deep understanding of the products and services available in the marketplace, and we have created strategic alliances with preferred carriers in order provide best-in-class benefits for our clients. The carriers we recommend are the carriers that offer the systems, services and products that best meet our clients needs. The pricing will be accurate and fair; we know this because the admin costs have been negotiated by our firm to be competitive, sustainable, and available to clients of all sizes.

Our Immix pools have been in place for over 15 years, and the strategy we have used has a proven record of sustainable and transparent pricing. This is a strategy that works for businesses of both small and medium size, and in some instances, even for larger companies.

I mention transparency because this is a key value for our firm. We strongly believe that you, as our client, have the right to see the (anonymous) claims details for your business. If you cannot measure and calculate year over year if your pricing is fair (as it relates to your health and dental benefits primarily), then how do you know if you are benefiting from the pool you are in?

One thing to beware of is that many “pools” will not provide you with the details of the claims experience for your group. How is this any better than the inaccurate/ unsustainable pricing offered from an insurer to obtain your business? How are you as a firm able to make reasonable and data-based decisions on plan design parameters if you cannot see the composition of your claims?



There are many advantages of being part of a Immix Group pool. Here are four key advantages to consider:

  •  Buying Power. Joining one of our pools provides buying power, as you can leverage economies of scale when it comes to plan design offerings, attentive service support, and most importantly, pricing. Even if you are a group of just 3-4 employees, you can gain access to the administrative costs usually reserved for a group with hundreds or even thousands of employees. This is quite simply not attainable on your own.

  •  Diversity. For our pools, we like to mix all sorts of industries and demographic profiles. The reason? Different types of groups have different claiming trends and are impacted in different ways from an economic standpoint. Over time, the patterns of one are offset by the patterns of another. We are not fans of industry-specific pools; from our perspective, they do not make sense. A diverse pool helps spread your risk and aids in keeping costs low.

  •  Transparency. As we said above, this is key. Knowledge is power and knowing the details of your claims experience empowers you to make the right decisions when it comes to your benefits. It also lets you know that you are getting the best value for your pricing. A key question for consideration is: “Why don’t the other pools out there disclose the dollar amount and composition of your claims?” To us, transparency matters.

  •  We handle everything. Service, service, service. At the Immix Group we handle everything from the initial set-up details to the daily administration that it takes to run your plan. For you, this means not using up in-house resources or using an additional party to handle the day-to-day. Plus, you have access to our knowledgeable benefits experts, who can help when unusual or problematic situations arise.


2020 has been a wild ride, but we were prepared

Given the current state of the world, if we were handling hundreds of benefits programs that were directly priced by insurers, we would be feeling very uncertain about the renewals that would be coming down the line. In contrast, we are feeling confident and exceptionally well-positioned to face the post-COVID benefit renewal.  This confidence is due to our well established, healthy and successful partnerships with insurance providers.

As always, we have been monitoring our clients claims on both an aggregate and individual level. We know the administrative margins, and in short, the ‘math’ that will be applied to this data. When it comes to benefits pricing, the strategy of your broker matters. In a world of uncertainty, it just makes sense to know all the details.  

If you’d like a review of your benefits plan, we’re always happy to help. 

Lindsay Byrka

Lindsay Byrka BA, BEd, CFP

Vice President, Immix Group: An Employee Benefits Company
A Suite 450 – 888 Dunsmuir St. Vancouver V6C 3K4
O 604-688-5262 E lindsay@immixgroup.ca
W www.immixgroup.ca

Trends & Free Resources in Digital, Virtual & Telehealth Care for British Columbia

By Howard Cheung, Account Executive, Immix Group: An Employee Benefits Company


As society navigates COVID19 and embraces the new norms of social distancing and virtual meetings, the way we access healthcare has possibly changed forever.

While many virtual options have long been available, people are adopting these at an increased rate out of necessity, and providers are responding to the demand with upgrades and new systems. Healthcare providers have rapidly adapted to providing services to patients, from inside the safety of their homes, many tailored to the health situations the pandemic has triggered or exacerbated. As well, during this time, many providers are stepping up to provide free resources.

We compiled a list of services, as well as other related information sources. As coverage varies from province to province, this article focuses on services available to those in British Columbia.  


Free Mental Health Support

The need for mental health support has never been greater. The impacts of the coronavirus are not only for those who have been infected. We are all dealing with uncertainty, fear, social isolation, as well as financial stress burnout, anxiety, depression- the list goes one. Accessing support can be done virtually:




Virtual Specialist Care through your benefits plan:

Many insurance carriers are now covering claims for virtual therapist and specialist care which may include:

  •  Registered counselling
  •  Psychological services
  •  Naturopathic services
  •  Physiotherapy
  •  Chiropractic services

Check with your specific carrier to confirm which ones they may cover, as well as if your chosen therapist provides online care.


On-Demand Medical / Virtual Doctor

  •  Pocket pills: Free to use online prescription fulfilment (no extra charges on top of usual cost of prescription), Can transfer your existing prescription. Easy. https://www.pocketpills.com 
  •  Babylon by TELUS:  The Babylon app is free to download and use. In BC, our provincial medical plan (MSP) covers doctor consultations on this platform, from your phone, right in your own home.
  • https://www.telus.com/en/bc/health/personal/babylon
  •  tiaHealth: Another online doctor service that can provide advice, referrals, requisitions, mental health support and more. Doctor consultations are covered under MSP. https://tiahealth.com/
  •  Medimap: Medimap provides access to a doctor virtually, nearly instantly. It also includes a handy tool that advises on the wait time for walk-in clinics, should you need to see a doctor in person.  https://medimap.ca/VirtualCare


Employee Assistance Programs:

Most employer sponsored extended health programs include some basic form of EAP. EAP providers have easy online access for their services. Check with your Employer on how to access your EAP.

In addition, most of the major EAP providers have free resources online. In particular, Morneau Shepell’s Toolkit for Individuals has a wealth or resources available for free. https://www.morneaushepell.com/ca-en/toolkit-individuals

For more details on how an EAP can help you, check out our article on http://www.immixgroup.ca/EAP.html

There are countless virtual options available to you. We encourage you to research the provider and ensure you are accessing qualified professionals, and that where possible, the services are free or covered under provincial or extended medical plans.

If you have any questions on digital healthcare, maximizing your digital benefits, or how to best restructure your benefits for optimal value, feel free to contact me: howard@immixgroup.ca

Howard 2

Keep Fit From Home

By Lindsay Byrka, Vice President, Immix Group: An Employee Benefits Company

We hope you’re staying home if possible, but that doesn’t mean you can’t stay active! As benefits consultants, it’s one of our goals to assist our clients in promoting physical and mental well-being; staying active is a key component of this.

As you are aware, with the COIVD-19 situation, gyms and fitness studios have closed for in-person visits. However, there are a wealth of resources online offering both paid and free workouts, some from your favourite local spots. Many offer a community environment, so you can not only break a sweat, you can feel connected!


If you’re not sure where to begin, here are some resources. We encourage you to support Canadian companies if you can!


Once you’ve decided which workouts you want to do, you’ll need to optimize your sweat-from-home plan. Here are some tips:

Figure out the best space to use.
You want to ensure you have room to move, and that you’re not going to be knocking over a lamp, or accidentally lunging into your coffee table. Clear a space, and gather any equipment you may need.

Figure out the best time.
If you live in an apartment, you may need to consider your neighbours (you don’t want your downstairs neighbour to be bothered by your jumping!). Plan a schedule that works around your work-from-home schedule, and try to stick to it! Scheduling reminders into your phone will help you stay on track.

Use the right gear.
You may or may not need shoes (and are they clean?!) depending on your workout. Based on your workout, a yoga mat, light weights or a stretch band may be all that is required. If you don’t have these items, don’t worry. There are many options for equipment-free workouts. Or, get creative and check out some ideas for DIY options: https://www.shape.com/fitness/gear/cheap-homemade-weights?slide=1bca6ca1-d936-4a2f-8ed3-06fb8d24bbef#1bca6ca1-d936-4a2f-8ed3-06fb8d24bbef

Whatever your workout, water is essential!

Warm up & Stretch.
Even if you’re working out in front of the TV or laptop, take the time to warm up for a few minutes, in case your virtual workout doesn’t include this aspect. Stretching either before, after or both is also very important. The last thing you want to have happen during this situation of self-isolation is an injury! If you’re not sure where to begin, there are a wealth of YouTube videos with simple warm-up and stretch routines. 

Lastly, involve your friends and family!
Why not make it a date? Your kids, spouse or friends (joining you virtually, of course) will all benefit from working out, just as you will. In this time when we’re all ‘alone together,’ finding things we can share is very important in maintaining our social connections.

Part of staying not just physically healthy but mentally healthy is keeping active. Although it’s harder now than ever, it’s also more important than ever.

From all of us at the Immix Group, stay safe, stay home, and stay active!

Lindsay Byrka

Lindsay Byrka BA, BEd, CFP

Vice President, Immix Group: An Employee Benefits Company
A Suite 450 – 888 Dunsmuir St. Vancouver V6C 3K4
O 604-688-5262 E lindsay@immixgroup.ca
W www.immixgroup.ca

Employee lay-offs and stoppage of work during COVID-19: Best practices for continued health coverage and premium management

Making the decision to lay off employees is not an easy thing to do. More than anything, many employers just want employees to be safe and healthy, and to return to work when operations are back to normal. Unfortunately because of cash flow pressures, many employers have been forced to lay off their staff, or are considering this move. While we are hopeful that the government support programs* detailed over the past days help employers to avoid layoffs, it is inevitable many will still need to take this step.

*The Government of Canada has released details on financial aid for both individuals and businesses, including a notable wage subsidy program, as well as the Canadian Emergency Response Benefit (CERB). These programs are intended to provide immediate financial aid, and to help businesses avoid layoffs during this time.  Please find details here: https://www.canada.ca/en/department-finance/economic-response-plan.html


Extension of benefits during layoff

For some, the reduction in expenses due to no longer paying wages is enough to ease the pressure. For others, benefits are also unfortunately being suspended. If you do want to extend benefits, and you’re able to do so, financially speaking, what should you be considering? There are numerous questions surrounding this:

  •  What is the process to do this?
  •  Which benefits are eligible for extension, and for how long?
  •  Can we apply for benefit premium reductions?
  •  Can we defer our program renewal?
  •  What else should we be doing?

To answer these questions, Employers need work with their Employee Benefits Advisors to assess the details. Here are some best practices to apply, and key guidelines to know.
*Note: This information is not specific to any one carrier as each has subtle differences. Due to the unprecedented nature of COVID-19, some of these are offered on an exceptional basis.


Typical layoff provisions in a benefits contract

In most benefits contracts, there is typically a layoff provision that allows benefits to be extended (with premiums paid) for up to 6 months. When the employee returns to work, they may be reinstated without any medical underwriting or requirement to serve the waiting period. Some carriers do not allow short-term and long-term disability to be included during this extension. And for those that do, most limit the duration of this to a shorter period than what would apply to the health and dental coverage.
 Furthermore, the provision could change depending on whether it is a temporary vs indefinite (no set recall time) layoff. Clients that do not have a layoff provision should review this and request one to be added.


Reduction in work hours and the impact on benefits eligibility

Many employees may be facing significantly reduced hours instead of a full layoff, and they may be below the minimum hours required to receive benefits. This is typically around 20-30 hours per week, or, you may have set your own minimum hours at the time your plan was established.
Some carriers are making an exception to this usual rule, and are not applying the standard requirements related to the minimum number of hours worked to be eligible for benefits. This is good news for those who wish to keep benefits running as usual.  


Deferral of your monthly benefits premium payment

As many Canadian businesses are facing financial strains, many carriers are offering to extend the payment grace period (normally 30 days) to 60 or more days. This means that member claims will not be suspended even if you cannot make your usual payment (up to a certain period). We believe this will continue to be offered, while business is affected in the manner we are currently seeing.


Deferral of your annual benefits renewal

For those on insured benefit plans, many carriers are helping to alleviate pressure on Canadian businesses by allowing renewals to be deferred. This means rate changes and any contract adjustments would not apply at the usually scheduled time. The deferral period varies from 1-4 months depending on the carrier, and this could change depending on how businesses are impacted going forward. So, if you have a renewal pending, and perhaps a premium increase had already been indicated (for example, for April 1st), this will not apply until later and a retroactive adjustment will not be required. This deferral does not apply to ASO (administrative services only) as these are self-insured.  In cases where you are expecting a proposed decrease in rates, that could still apply so that you are not losing out on any reductions.


Partial reduction of benefits coverage

To help alleviate financial difficulties while still wanting to provide vital health benefits such as drug coverage, most carriers are allowing certain benefits to temporarily be removed. In turn, this can reduce your premium. The most relevant benefit line for which this is applicable is the dental portion of the plan, as dental offices are currently closed. Dental premiums may be significant, and even up to 50% of your entire monthly benefits premium. Please note that this change would apply to the whole group, including active employees.


Temporary suspension of all benefit lines

Some businesses may wish to temporarily suspend their entire benefits program due to economic uncertainty. If all benefits have to be fully suspended for all members (laid off and active) then some carriers are allowing premiums and claims to be temporarily stopped for 3-6 months with no administration charges for reinstating. During a period of suspension, it is important to note that any claims incurred, including disability claims, will not be covered. This is an extreme measure.

It is important to note that there will be no waiting periods nor medical requirements (evidence of insurability) to reinstate employees when it is time to get benefits back up and running.


This is the time to promote your EAP

COVID-19 isn’t just affecting employees’ physical health, it’s causing mental health issues due to job and family stress, isolation, and general anxiety about the situation. Employer-provided mental health programs like EAP (Employee & Family Assistance Programs) can have a positive impact. So don’t forget about communicating the access details for your EAP if you have this included in your benefits program (a lot of plans include at least a basic EAP). EAPs can help with personal, emotional or work-related problems that affect health, mental or emotional well-being. They are available 24/7 in multiple languages!


Assess your Employee Benefits strategies

In short, businesses can continue to help support their employees’ health by continuing employee benefits via a variety of strategies to help alleviate financial pressures. Even if it is a full benefits suspension, it is essential to work with your benefits advisor to ensure the details are handled properly. With all the daily changes, keeping an active communication channel with your benefits advisor is important during this time.

As a consultant with the Immix Group, a full-service benefits firm with innovative solutions, we want to help. We are offering free consultations to any Canadian business, regardless of whether we are already partnered in business or not. We can work together to determine the best strategy for your situation.

For more information, please feel welcome to contact me: howard@immixgroup.ca

Howard 2

Market Update: Stay Calm, Stay the Course

By Anthony Ciccone, President

A message from Anthony Ciccone, President

Many of you are feeling concerned about the unprecedented events we are experiencing, and specifically, the severe impact on the financial markets. Three months ago, no one knew what COVID-19 was; now it is impacting everyone. This is uncomfortable; we are all feeling the angst. The ups and downs of the stock market over the last few months are a great reminder as to why being well-prepared is essential.

Perspective is vital in times like this. Throughout history, there have been dramatic upswings and downswings; but it also leads to lessons on what we should do and not do, when it comes to our investments. Here are three things everyone must think about. 


  1. Context is key. Over the past decade, the S&P 500 has averaged an annual return of 13.8%. The S&P 500 is now giving up years of returns, and it feels scary. What we can control is our own actions. Everything else is out of our control. The best thing to do is be well informed, have patience, and trust the process of your plan.
  2. Please stay invested. Over the past 11 years, we have seen very little volatility. The start of this extreme volatility, which started around one month ago, was only the 6th real drop in 11 years. Before this, the most significant drawdown was in 2018 (20%). Corrections are typical market behaviour. Being comfortable with market fluctuations is important as you should not be chased from the stock market, especially if you have a long-time horizon. 
  3. Diversification. We are exiting a cycle of low volatility, scarce drawdowns and high investor complacency. Many people, wanting to take advantage of the extended period of growth, didn’t see the purpose in owning bonds or negatively correlated assets. March 2020 has shown us the timeless lesson of diversification. There should always be investments in a portfolio that are designed to help when markets don’t go the way that is expected. Losing less right now means recovery is quicker once the markets turn around.


Risk makes everyone nervous, but it is also where the return comes from. As it works against our investments, as we see now, it can be abrupt and scary. True wealth is built by being disciplined in our plan and investments. 

Staying true to your plan, staying invested and staying diversified will be the most opportune way to weather the coming storms and capitalize on gains once the recovery emerges. 

If you’d like to discuss your account one-on-one, please feel free to call us at 604-688-5559.

anthony ciccone

Anthony Ciccone

President, Immix Group: An Employee Benefits Company
A Suite 450 – 888 Dunsmuir St. Vancouver V6C 3K4
O 604-688-5262 E anthony@immixgroup.ca
W www.immixgroup.ca

EAPs – how these programs can benefit both employees and organizations

By Lindsay Byrka, Vice President, Immix Group: An Employee Benefits Company


You may be familiar with the acronyms “EAP” or even “EFAP.” Perhaps you have a general or at least vague idea about these plans. But, like many people, you’re not exactly sure what they mean or how they work. Lacking a solid understanding, you aren’t sure if providing an EAP or EFAP would hold true value for your team.

Whether you’re an HR professional, a program’s plan administrator or an employee who is a member of a benefits program, it’s to your advantage to know about EAPs. In this article we will try to answer the most common questions about them.

Firstly, EAP stands for Employee Assistance Program. Lately providers have started referring to it as EFAP, for Employee and Family Assistance Program. For the sake of simplicity, we’ll use EAP here.

EAPs originated in the 1970s. They developed out of programs that assisted employees with alcohol problems. The first EAPs included mental health and family problems, keeping addiction still as a central tenet. Today, the scope of these programs is vast, with mental wellness as their guiding principle.

The purpose of these programs is to provide access to support and resolution for problems that are affecting work. However, such problems don’t necessarily have to stem from the workplace. In fact, it’s just as likely that they don’t.


What services does an EAP include?

An EAP covers voluntary, free and confidential assessments, short-term counselling (via online, telephone or limited in-person contact), referrals and follow-up services.

The personal and work-related problems may include (but are not absolutely limited to):

  •  interpersonal relationship problems
  •  parenting issues
  •  eldercare issues
  •  drug and alcohol/addiction issues
  •  financial concerns such as debt management
  •  basic legal assistance
  •  general anxiety, stress and coping skills
  •  grief and bereavement
  •  weight management and nutrition
  •  critical-incidence response.

Taking it further, most major EAP providers also offer organization wellness initiatives. While these services are typically included in more robust, stand-alone plans (as opposed to the type of EAP embedded within an extended health-care offering), the services can often still be accessed if required, for a fee.

For companies with comprehensive programs, the organization wellness programs provide education, motivation and intervention in various areas, including:

  •  managing workplace bullying
  •  employee diversity training
  •  harassment prevention
  •  stigma reduction strategies
  •  crisis management
  •  effective communication strategies
  •  workplace issues interventions
  •  customized coaching and assessment
  •  disability prevention, including trauma/depression/anxiety/addiction care
  •  onsite workplace trauma response and follow-up support, e.g., for post-traumatic stress disorder (PTSD).

Most providers are available 24-7, 365 days per year, in a variety of languages, and can give support via a multitude of media.


How does an EAP work? Is it really confidential?

Plan members are often concerned about privacy. According to the most recent study by the global healthcare leader Sanofli, only 65% of employees are confident their privacy will be protected. Their fears are understandable – but don’t reflect reality. Being key to the success of these programs, confidentiality is respected and staunchly upheld.

Generally speaking, the providers of EAPs are barred from reporting any details to employer or benefits advisors. They may share a limited amount of aggregate data to assess the usage of the program. But confidentiality as to who specifically is using the plan, and for what issues, is maintained as paramount to the process.

In fact, a lot of the time assistance can be accessed without providing full details as to the identity of the person accessing the service. A simple policy number is often enough.


How much does an EAP cost?

The good news is that many insurance carriers include employee assistance programs as an embedded plan feature within the extended health benefit.

Typically, the embedded programs are more limited in scope than a stand-alone program. However, as mentioned earlier, for very reasonable fees you can often purchase one-off services when the need arises. And typically an hourly rate would apply, varying based on the specialist you required.

For a stand-alone plan, the cost tends to be charged as a fee per certificate (meaning, covering the employee and all their dependents) per month. The costs range from around $3-$6 per employee, per month. That’s just $36-$72 per employee per year!

It’s worth noting that, according to industry information on EAPs’ return on investment, for every $1 put into EAPs, the return is eight times over.

The bottom line? This is quite simply a very affordable and valued benefit.


Can you expand on the benefit of offering an EAP to employees?

The goal of an EAP is to help employees to get better, and/or to address the problems that are preventing them from doing their best work.

Even large organizations with specialized staff do not have everyone in-house to adequately address the unique situations that may arise in the course of life and business. At an organizational level, implementing an EAP or expanding your program means being prepared to engage specialized professionals when needed. For the employee, this means having the right person for the problem, right at their fingertips.

The benefits are limitless when it comes to the person’s personal well-being. When we’re talking specifically about the impact as it relates to work, here are a few specific goals:

  •  improved productivity – distraction by personal problems has a major impact on job performance
  •  reduce absenteeism
  •  reduce healthcare costs/gradually see lower usage of the plan
  •  prevent escalation of issue involved.

There is a very obvious trickledown effect. Improved employee wellness fosters a positive work environment, which helps to retain employees. The fact is: People stay at jobs because of good relationships with their managers and coworkers.

By assisting your team in achieving personal well-being, you’re positively impacting everyone.


Why should I implement this for my employees? Can’t they get help on their own?

Even the best-equipped among us often find ourselves without a clear path or answers to our quandaries. For many, an EAP may be the only thing available to help. Not implementing an EAP assumes employees have their own resources, networks and the knowledge to seek out appropriate care and guidance for either crisis or non-crisis situations that may arise in their lives.


We have a plan. Now what?

Awareness is key. Unfortunately, awareness when it comes to benefits is statistically low. Study after study tells us that there is a low level of awareness on the part of both benefit plan administrators and employees with regard to the benefits available to them – and how these benefits actually work.

Even when efforts are made to communicate the details of benefits programs, there is a disconnect. Over 90% of the time, employers report thinking communication was “good or very good.” Unfortunately, most employees totally disagree (Sanofi study).

So, what can an employer do? Here are some suggestions:

  •  Heighten awareness: constant reminders are needed, in a variety of formats
  •  Be clear about the scope of the areas the program addresses
  •  Be clear about the many ways to access it – even better, demonstrate if possible
  •  Reiterate the confidentiality of the plan.


While an EAP is just part of an overall strategy to address workplace wellness, it can play an integral role in assisting employers to foster positive mental-health strategies in that workplace.
If you don’t have an EAP in place, we can help. The consultants at the Immix Group can assist you in determining a program that addresses the needs and goals of your organization – while still fitting your budget.


For more information, please feel welcome to contact me: lindsay@immixgroup.ca

Lindsay Byrka

Lindsay Byrka BA, BEd, CFP

Vice President, Immix Group: An Employee Benefits Company
A Suite 450 – 888 Dunsmuir St. Vancouver V6C 3K4
O 604-688-5262 E lindsay@immixgroup.ca
W www.immixgroup.ca

This might just be the right time for you to implement an employee group savings plan – here’s why and how

By Lindsay Byrka, Vice President, Immix Group: An Employee Benefits Company


With RRSP season winding up – the deadline for 2019 RRSP contributions is March 2 – you may be debating if now is the time to implement a group savings plan for your team.

In working with our clients to implement and manage group savings plans, we come across a number of questions and misconceptions. For example, a common incorrect assumption is that implementing a plan will be costly or difficult.

In this article, we’ll try to give you clarification around the why and how of these plans.


First of all, what do we even mean by a group savings plan? Is this a pension?

While you may think of an employer-sponsored plan as a pension, these days a Registered Pension Plan (RPP) is less common than other types of employer-sponsored savings programs. We can certainly still offer pension plans, but we are finding that most employers now choose other options.

When we talk about a group savings program, we typically mean a group Registered Retirement Savings Plan (RRSP), often offered in combination with a Deferred Profit Sharing Program (DPSP) and Tax-Free Savings Account (TFSA) option. This is the typical composition of most programs we set up for our clients.

While the above may seem like a lot of acronyms all at once, they’re much less complicated than you may fear.*


Six reasons you should consider implementing a group savings program:

  1. It’s cost-effective. Generally speaking, other than a very small amount of administration time, the only cost to you as the employer is whatever you decide to contribute to your employees. If it’s just not in the budget, you can still set up a plan that is for voluntary employee contributions only.
  2. It’s part of a comprehensive benefits offering. If you’ve already implemented a comprehensive health benefits program, and you’re paying competitive salaries within your industry and for your location, the next step is implementing a group savings program.
  3. It gives your company a competitive edge. Despite the process being simple and easy, most employers are not providing their teams with the opportunity to join an employer-sponsored group savings program such as a group RRSP, TFSA or DPSP. These employers aren’t taking advantage of this very simple, very meaningful way to help reward employees and cement their loyalty. Implementing a plan makes your company stand out- in a good way.
  4. Help your team to succeed. Saving money is hard, and it’s stressful. Show your employees that you care about them and their future. Help them to save for their goals, whether it’s for a down payment or for retirement. Just as with employee health insurance plans, your team will truly appreciate a group savings program. These plans are highly valued, far beyond the dollar equivalent in a salary raise.
  5. It’s tax-effective. Properly set up, a group savings plan provides tax advantages to both the employer (contributions can be tax-deductible to the business) and the employee (reduced income tax payable). Employees are often surprised to learn they can reduce their income taxes through a payroll deduction to a group savings plan.
  6. It’s incredibly easy. We promise: This is one of the simplest programs to both implement and manage. As you’re required to be hands-off in many respects (for example, you cannot provide investment advice to employees), you are really just facilitating access for your employees. Our team of advisors at the Immix Group can handle the details, along with your chosen investment provider.


Is my company large enough to offer a group savings program?

Most likely, yes. A common misconception is that a small or mid-sized company is not large enough. However, you do not need to be a large organization to offer a group savings program such as a group RRSP, TFSA or DPSP. With just a handful of employees, you can implement a plan that is competitive with those of much larger employers.


Is there a lot of administration or complicated paperwork involved?

No. Set-up is simple, and the majority of that set-up is done by our office of benefits advisors and the carrier with whom we decide to provide the group savings program platform. With today’s technology, the systems (online and mobile) available to small and medium organizations are very impressive. These systems offer employees real-time access to managing and tracking their financial and retirement planning. Administration by employers is simple and is basically limited to enrolment and termination of members, and remittance of contributions to the carrier.


Are there hidden costs such fees charged by the investment carrier or the advisor?

No. The fees are taken off the investment returns prior to being distributed to the members of the plan. For example, if an investment had a return of 10%, and the investment management fee were 1%, the employee would simply see a 9% return.

While there can be some small one-off charges, these are uncommon and for unique, infrequent situations. In the typical day-to-day administration of the plan, the employer and employee would not be subject to admin fees or service charges.


How do I take the next step, and implement a plan?

Enlisting a benefits consultant such as one of the advisors at the Immix Group is the first step in setting up a group savings program. We can walk you through several steps:

  •  Outlining a variety of options that fit your budget
  •  Ensuring you understand the various tax details that are relevant to you
  •  Helping you in selecting the right plan
  •  Rolling it out to your staff
  •  Ensuring education opportunities for staff, both as a group and individually
  •  Managing it going forward.


When it comes to a group savings program, set yourself apart as an employer: Offer your people the opportunity to save for their futures. As noted earlier, it’s easy – we promise!


For more information, please feel welcome to contact me: lindsay@immixgroup.ca

*Group RRSP: a Registered Retirement Savings Plan. Just like the individual one you may have, but sponsored by your employer, and with contributions made via payroll deduction. A RRSP allows for tax-deferred investment growth.
Group TFSA: A Tax-Free Savings Account; just like the group RRSP, a Group TFSA is simply a TFSA sponsored by your employer. This allows for tax-free investment growth.
DPSP: a Deferred Profit Sharing Plan. This is for the employers’ contributions, and also offers tax-deferred growth on investments, similar to a RRSP.

Lindsay Byrka

Lindsay Byrka BA, BEd, CFP

Vice President, Immix Group: An Employee Benefits Company
A Suite 450 – 888 Dunsmuir St. Vancouver V6C 3K4
O 604-688-5262 E lindsay@immixgroup.ca
W www.immixgroup.ca

New Year, New Benefits?

A fresh year — and a refresh opportunity

For more information, please feel welcome to contact me: lindsay@immixgroup.ca

Lindsay Byrka

Lindsay Byrka BA, BEd, CFP

Vice President, Immix Group: An Employee Benefits Company
A Suite 450 – 888 Dunsmuir St. Vancouver V6C 3K4
O 604-688-5262 E lindsay@immixgroup.ca
W www.immixgroup.ca

Employee benefits vs. a straight salary raise: One is significantly better for your business

The old-school view would tilt toward getting a raise, on the theory that a bird – well, okay, a bunch of dollars – in the hand seems the more tangible value. But when you do the deep-dive financial analysis, offering benefits worth the same amount comes out on top.


Let’s take a closer look. A good benefits package for an employee with full family coverage is around $3,000 annually as premium. If this $3,000 were to be implemented as a salary raise, it would translate to a higher employer payroll tax. Moreover the employee would lose out because it is taxable income. So, the $3,000 annual raise wouldn’t be worth as much to either employer or employee.


By contrast, if you go with a benefits program, there are tax advantages to both of you. Employee benefits premiums paid by the employer are tax-deductible to the business and mostly a tax-free benefit to the employee (health and dental are non-taxable). The thing is, the government of Canada wants to reward companies that take care of their employees. The government understands that, for the long term, enhancing employee benefits is not only better for our economy but for overall health of our country.


From a psychological standpoint, the perceived value of receiving a benefits package is also higher. Here’s where genuine tangibility comes in (sorry, old-school types). People will real-life experience the employee benefits program by using it for dentist visits, physiotherapy appointments, at the pharmacy, and more. Employees will engage with the program repeatedly throughout the year, both for themselves and their families.


This is especially true when the business enlists a professional benefits consultant. Savvy advisors help engage the employees by taking them step by step through all aspects of the benefits program via:


  • education sessions
  • clear communications
  • phone-call and e-mail availability to answer questions, and
  •  access to useful benefits tools.


Offer the best to attract the best

Last but by no means least, another reason companies provide good benefits is to increase their competitiveness. A solid benefits program helps attract top talent and retain a strong team. To maximize your company’s attractiveness to that top tier, make sure your benefits are designed to be truly valuable, not just some superficial, cookie-cutter plan.


Because one size emphatically does not fit all – and that’s where employee benefits consultants come in. They work for your company based on your unique employer and employee needs, as opposed to some slashed-rate, self-serving broker bartering whatever happens to be the benefit-market condition of the day. Don’t settle for the latter. When an employee leaves your company, it costs you time and money. Your turnover cost isn’t just in lost productivity, but replacement costs, advertising the position, time spent on interviewing and, of course, training the new individual you finally hire.


To recap, as a business owner you will appreciate – and profit by – being aware of the tax advantages employee benefits programs provide, both to employer and employee. Your business will enjoy the derived benefit of hiring and retaining an excellent team. Once you have that solid, top-tier-attractive program installed, you’ll see that employee benefits actually serve you as “HR insurance,” if you will.


For more information, please feel welcome to contact me: howard@immixgroup.ca

Howard 2

Employee benefits for start-ups: the long-term vs. short-term outlook

Once they grow above three employees, many small businesses start thinking about getting a benefits program. After all, benefits are a key attraction in hiring the best talent.

From a human resources perspective, small businesses scaling up should make sure the benefits package they settle on is competitive. Contrary to popular belief, it’s not enough to shop around for providers that offer the best rates. Let’s look at the factors to be aware of — and if they align with your business philosophy.

A lot depends on whether you’re in it for the long or short term. Pose this specific question to potential providers: “How do benefit premiums work and what are they going to cost in a five-year timeframe?” Be aware that insurance providers can offer seemingly discounted rates to lure you in initially — then, a year or two later, significantly bump up those rates. Now, if your initial budget is tight and you know that your rates will go up by double digits annually, then that’s fine. But this eventual bump in rates should be made transparent to you from the get-go.


Other options

Then there’s the opposite scenario: A provider advises you to sign on for higher-than-average rates for your group. The reasoning is that, with higher rates, the provider will have more room to play with should you run into a high-claims situation. So, do you want low rates with higher risk or higher rates with lower risk?

Or, you could opt for the right optimal rates. But what determines an optimal rate? To get a better idea, you have to understand how premiums are derived. Ultimately, premium rates are based on a combination of factors:

  •      claims paid vs. premiums paid (a.k.a. experience)
  •      trend factors
  •      pooled vs. non-pooled benefits
  •      profit margin/admin cost/commissions (a.k.a. target loss ratio).

We won’t go into exact technical explanations, but it’s important that you are aware of the above. In our consultations and renewal reviews, we delve deeper into each factor and explain how it is intertwined with your premiums. Interestingly, most people are aware of the first three factors; few know about the fourth one. Many clients have found it eye-opening to understand how brokers and insurance companies get paid. Understanding all this, we are often able to optimize costs in the long term.

In short, if you have a long-term outlook, don’t just focus on the surface rates of quotes and benefits. Rather, think about the underlying factors that will affect your company’s experience and rates in the long term. Consider doing an audit on your benefits with the above perspectives in mind.

ImmixGroup are group benefits specialists who provide transparent consultation and optimization of benefits for businesses.

Howard 2

BC’s new Employer Health Tax starts January 1––
Here are 3 things every employer must know

Many British Columbians welcome the abolishing of public healthcare premiums. They see the move as a huge step towards a truly free healthcare system.

But what are the potential cost impacts? Here are 3 things employers should note and prepare for.


1. Companies with payrolls over $500K may have to pay both EHT and MSP premiums

The NDP government announced that the Employer Health Tax (EHT) will come into effect January 1, 2019. The Medical Services Plan (MSP) premium will be removed January 1, 2020. This could mean that companies currently sponsoring MSP for their employees will have to pay the EHT while still budgeting for MSP. However, there will be no additional impact for small businesses with $500,000 or less in payroll.


2. The actual cost calculation of EHT

  •      As mentioned, companies with a payroll of $500,000 or less will not pay EHT
  •      Companies with payrolls between $500,000 and $1,500,000 will pay tax at 2.925% above $500,000
  •      Companies with payrolls greater than $1,500,000 will pay 1.95% on their total payroll.


Here’s a handy quick calculator for you.

Not surprisingly, many BC business owners are less than thrilled about the new tax. But keep in mind that many other provinces already have payroll taxes in place. The province with the highest payroll tax is Quebec, at 4.26%.


3. Dividends are not included in the calculation of payroll for EHT––but what is?

The following are included in the calculation of EHT:

  • Salary and wages
  • Bonuses, commissions and other similar payments
  • Vacation payments
  • Gratuities or tips paid through an employer
  • Taxable allowances and benefits
  • Directors’ fees paid to directors of corporations
  • Amounts paid by an employer to top up benefits (e.g., top-ups for maternity or paternity leave)
  • Stock option benefits
  • Employer-paid contributions to an employee’s Registered Retirement Savings Plan
  • Employer-paid group life insurance premium.


In cost terms, the new EHT will significantly affect many of our clients in a negative way. What are your own thoughts on the impacts? Is the upcoming change truly the next step towards 100% free public healthcare? We’d love to hear your views. And let us know if you have any questions!

Howard 2

Exclusive: Our report on the Vancouver Cannabis Trade Show 2018

In Canada this year, we’ve seen much progress and many changes with regard to cannabis legislation. At Immix Group, we are committed to providing active updates to you on the legalization of cannabis – and how this may change the healthcare landscape. As part of keeping you up to date on where the industry is heading, we attended the recent Vancouver Cannabis Trade Show.


Here’s our report to you:

At the show, we observed very professional-looking vendors and producers of cannabis derivatives such as oils, creams and topical balms. Cannabis-infused pet products were also a big hit. I even found one vendor selling what seemed to be designer wooden sunglasses – only later to find out that these glasses are designed to block out the harsh lights often used to grow marijuana.

Overall, our impression was that the industry is aiming to become mainstream. One day soon, you will likely find topical cannabis balms on the shelves at London Drugs and Shoppers Drug Mart.

Surprisingly, there was zero trace of cannabis scent. Note that at the time of writing this report, cannabis will be legal in Canada on October 17, 2018. And while a certain demographic is concerned about the psychedelic effects of cannabis, we found that many vendors are trying to target and capture the healthcare market for pain management and healthcare alternatives. Their focus is to cure or alleviate ailments such as migraines, headaches, arthritis, stress, anxiety and stiff back and muscles.

One thing is for sure. Things are changing in the Canadian healthcare system! Medical cannabis could definitely play a role in positively impacting the medical industry. Vendors could soon provide a low-cost alternative in easing various types of illness and pain. In Vancouver especially, the demographics and culture seem to match well with the adoption of medical cannabis.

When do you think your family doctor will start to recommend medical cannabis as an alternative healthcare solution? Or have they already? Let us know! We’re interested to hear from you.

If you have any questions about our benefit programs and medical cannabis coverage, feel free to contact us: howard@immixgroup.ca

Howard 2

HR managers: Here are three useful tips to help you efficiently manage employee benefits

Employee benefits are an integral part of both the employee-value proposition and the overall working experience. As an HR manager, you might well ask, “Just how deeply should I be involved in employee benefits?”

Let’s be frank. The discipline of employee benefits can be overwhelmingly complex. It takes in administrative processing, financial analysis, reconciliation and compliance. And, given that the cost of benefits is huge, you may even be responsible for negotiation and auditing.

To help you efficiently manage employee benefits, here are three tips:

Use and take advantage of online technology

Check with your broker to set up your group plan with:

  •  a plan administrator’s online platform
  •  members’ online platform
  •  a mobile app for members.

At a minimum, most insurers have an online administration platform to do a majority of traditional tasks: enrolment/termination/changes for members; viewing invoices; viewing coverage; etc. As for implementation of benefits, don’t sift through hundreds of paper applications. Instead, ask your broker if they can support electronic enrolment of members.

Encourage employees to use the members’ online platform to check coverage balance, replace lost cards and use best practices for travel/special claims. As well, more and more insurers have mobile app support. This allows easy, at-their-fingertips access to all of their benefit details. The more self-servicing resources provided to members, the less manual work falls to the HR department.


Implement an employee assistance program (EAP)

A key role of HR is to support employees in cases of workplace crises stemming from a variety of factors: mental illness, personal issues, financial stress, substance abuse, etc. All these can lead to performance issues and absenteeism. As well, they put a lot of stress and burden on the HR department.

Fortunately, a strong EAP is a powerful partner for HR and can help address all of the above with minimal disruption to business.An EAP is designed to assist employees in resolving the above issues via: counsellors over the phone or online; referral services; and wellness resources. Many EAPs also offer coaching and assistance to managers and HR in dealing with employee issues, such as workplace conflicts.

The key benefit of such a program is that it is anonymous and confidential, with expert resources for employees. Often political and privacy factors are at play that prevent employees from seeking help through their employer. As issues continue to linger, performance and ultimately the efficiency of the business will be adversely affected. All businesses, small or large, should consider taking advantage of a strong EAP as a cost-effective solution in alleviating workplace crises.


Work with a dedicated benefits broker

Benefits can involve many layers of management. It is a good idea to work with an employee benefits brokerage that has a dedicated team for servicing and consultation. This means not using the insurance company or an independent financial advisor without an in-house team. By contrast, a dedicated benefits service team can help coordinate and negotiate claims that could otherwise be declined by the insurer.

A specialized benefits broker can provide better insights; they have a wider range of tools and better pooling arrangements with insurers. These advantages lead to optimizing the cost of your employee benefits program. This is especially important at renewal time, when a benefits broker can make sense out of your multi-page renewal report and guide you through the nuances of benefits analysis.

At Immix Group, we believe implementing the above three tips will significantly optimize the administration of benefits in HR. As employee benefits specialists, we work closely with HR so that we are the ones doing the brunt of the heavy lifting in:

  •  market surveying
  •  benchmarking
  •  financial analysis
  •  negotiation with insurers
  •  securing pooling arrangements
  •  auditing.

When benefits are efficiently managed, both you as the HR manager and your workforce are better able to focus on running your business.

Further reading

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Your employee benefits program: Five important questions to ask every year

It is vital that you run a sustainable, healthy employee benefits program tailored to your organization’s needs. As your company changes and grows, be aware that one size does not fit all. Update your program to ensure you continue getting the maximum value in providing benefits.

Whether you’re the business owner, human resources manager, chief financial officer or cost controller, you want to keep your employee benefits program effective. Here’s how to do that. Every year, ask your broker the following five questions:

  1. What is my benefits program’s expense ratio, that is, target loss ratio (TLR)?

    Knowing and understanding your TLR allows you to compare the expenses of an insured plan, as opposed to comparing the rates/coverage alone. TLR indicates how much money the insurers take away from your premium dollars to run the plan. When organizations compare only the actual rates, i.e., when they “rate shop,” they get sucked into market-surveying every year, and possibly frequent carrier-switching. Don’t fall into this trap. It will lead to inefficiencies for both your organization and the insurers – and ultimately to significant financial costs.

  2. An employee assistance program (EAP) is the number-one way to decrease: a) absenteeism and b) long-term drug costs. Does our plan include an EAP?

    In Canada, anti-depressants are one of the highest-claimed classes of drugs. They could be the root cause for your group plan’s annual premium increases. Depression and other mental illnesses may stem from issues outside the workplace that nevertheless influence the workplace. So, even if there is a healthy work environment, personal issues out of your HR’s control can affect absenteeism and presenteeism. When such issues are left unattended, employees often wait too long to seek help. The best way to combat mental illness is to be proactive rather than reactive (i.e., taking drugs). An EAP is the most cost-effective way to have a confidential third-party, professional resource for your employees to access, whether it is for personal or workplace-related issues. An EAP not only eases your HR burden; it also fosters a healthier mindset in the workplace.

  3. In case of an unfortunate life event, are my executives and I adequately covered by long-term disability (LTD) and key-person insurance?

    While most group plans include group LTD, you want to ensure that the amount and the definition of coverage are adequate. A common mistake is failing to understand that, after the “two-year own occupation” clause, LTD benefits can end if the disabled employee can do any other job. Furthermore, it is important to ensure that key persons vital to the operation of your business are covered in case of any unfortunate, unforeseen circumstance. Suddenly having to hire a replacement executive would not only be costly; it would drain much of your time and resources. Key person coverage is designed to pay the business in the event of losing a key employee or owner.

  4. A health spending account (HSA) enhances benefits flexibility. Is HSA suitable for an organization of my size?

    HSAs are a great way to provide flexible benefits under a controllable financial structure for a small start-up. They’re also an excellent supplementary benefit for larger organizations with an existing traditional benefits program. Members get a set annual amount that can be used for anything Canada Revenue Agency deems eligible as a medical expense. Furthermore, a related type of account, a lifestyle spending account, may even be used for wellness-type expenses, such as yoga classes, supplements and gym memberships (i.e., non-CRA eligible). As of March 2018, setting up HSAs is also one way to provide coverage for medical marijuana.

  5. At what point should I look into shifting benefits money into Administrative Services Only (ASO) funding in order to minimize insurance administration costs to run the benefits program?

    ASO is indeed a way to reduce the administrative costs in running your benefits program. It shifts the risk from the insurer to your organization. Based on the plan design, you pay the provider to administer and manage claims for you. Why do this? Because you optimize the reach of your healthcare dollars. Note: This is only appropriate for larger groups. Once your organization comprises more than 100 people, claims volatility is typically low enough for a group to take on the risk. This is especially applicable if you consider ASO for just dental, where there is typically a cap in usage. ASO can immediately save 5-15% of your benefits costs, provided your group has low enough claims volatility.

By asking the above questions, you will have a much better understanding of how your benefit program should run for maximum optimization. If you would like further clarifications, please feel welcome to contact me: howard@immixgroup.ca. I will be more than happy to answer your inquiries in detail!

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March is Fraud Prevention Month – and you can help!

Benefits fraud is a topic that just keeps trending. There’s good reason for that. Fraud is a huge problem within the world of benefits. It impacts everyone – and it hurts everyone.

Benefits fraud is insidious. It takes all forms. Plan members, plan sponsors and service providers: All have been complicit in acts of fraud.

The financial impact is significant. While estimates range, industry experts’ best guess is that two to 10% of healthcare dollars – that’s up to $12 billion per year – are lost to fraud. This is money that could pay for a lot of legitimate, much-needed expenses!

Two of the most common complaints we hear from employees are about:
1) the cost of their benefits
2) what their plan doesn’t cover.

The irony is that, the more a plan covers, the more it costs. And, when fraud sucks away valuable healthcare dollars, it directly impacts the quality of the coverage that can be provided to members.

The bottom line is this. A benefits program needs to be financially viable – and benefits fraud is a massive drain on the precious resource of healthcare dollars.


What you can do as a plan member to fight fraud

  1. Double check each of your claims, especially if you did not personally submit the claim. You can check your claims history online. With most carriers, you can check right from a mobile application.

  2. Make sure that each claim is genuinely your claim. A common way providers commit fraud is by submitting a claim on your behalf for a service that was never performed, or for a claim in excess of what was provided.

  3. No question direct claiming is convenient, but… Direct claiming means the provider offices have access to your benefits program details. While we like to trust our dentists, physio clinics and optometrists, the unpleasant reality is that some of these providers are the very ones committing the frauds. Keep your benefits information confidential to the greatest extent possible. Never sign blank claim forms.

  4. If you do get audited on a claim, don’t be offended! Auditing is an important part of ensuring claims’ accuracy.

  5. Lastly, don’t “accidentally” commit fraud! Maybe you think you’re just getting a good deal. For example, you have the chance to get sunglasses instead of prescription glasses through your benefits plan. Think again. Not only will this inaccurate reporting impact the financial viability of your program; it will be fraud. You could be charged with a crime you never intended to commit.


Real-life stories of fraud

We recently learned of a plan member who noticed that his Vision Care benefit (\$200 per person every two years) was used up for all five members of his family. Knowing his family members had not all made claims, he looked into this – and discovered the provider had submitted false claims to the insurance company.

The provider was paid $1,000 ($200 x five family members) by “claiming” for eyeglasses, contact lenses and eye exams that the family had never purchased!

How did this happen? The provider had the plan information on hand based on a previous visit by one of the children for an eye exam.

Because of this fraud by the provider, the benefits program incurred \$1,000 in claims – adversely affecting the cost to the employer and ultimately the employee. Furthermore, this benefit then appeared to be ‘used up’ for the member and his family. If they had needed to make a real Vision Care claim, it would have been rejected.


Here’s another true story.

We learned of an employee in a dental office who was entitled to free dental services. Despite this, she submitted claims for herself, utilizing her employer’s access to the direct claiming system, under her partner’s benefit program. The system accepted the claims (the insurance coverage was valid), not knowing the member had never paid for any of the services.

Her defence? “I am covered for a benefit I don’t need…so therefore should be able to receive a payment back to make up for the cost of our premiums.”

Nope. You committed fraud.


Help us and help consumers. Report fraud!

Through their online and mobile applications, insurers provide tools to show how much you’ve claimed, along with the details of your claims. These tools are not just for your convenience. They help ensure the accuracy of the claims going through under your name.

The following is essential: If you notice something strange, something off, something not quite right in your claim records – report it at once to your HR, or directly to the insurance carrier.


Further reading

Canadian Life and Health Insurance Association (CLHIA) tips:

Pacific Blue Cross (PBC) Whistleblower hotline: 

Lindsay Byrka

Lindsay Byrka BA, BEd, CFP

Vice President, Immix Group: An Employee Benefits Company
A Suite 450 – 888 Dunsmuir St. Vancouver V6C 3K4
O 604-688-5262 E lindsay@immixgroup.ca
W www.immixgroup.ca

Employee benefits renewal is simpler than you think – here’s the key

You may be an accountant, or work in human resources. Or perhaps you are a cost controller, chief financial officer or small-business owner. In any of these roles, you face the same daunting challenge every year: At employee-benefits-renewal time, how best to deal with rate adjustments while keeping costs under control?

Renewal reports can be mind-bogglingly complicated. They don’t have to be. Yes, you have a great deal of data to consider in understanding your group’s claim usage. But there’s a key factor that defines your renewal adjustment.

This factor has to do with:
1.) target loss ratio, or TLR, and
2.) two formulas that will help you understand where your renewal should stand.

TLR, sometimes also called a break-even ratio, is a percentage that indicates the expense level of the insurance carrier. This expense level directly affects how much your group can claim before the insurance carrier loses money.

For example, let’s assume your TLR is 80%. First we need to calculate the loss ratio, which is claims paid/premiums paid. In this case, let’s assume claims paid were $90 and premiums paid were $100:

  • loss ratio = total claims paid/total premium paid
  • estimated adjustment = loss ratio/target loss ratio.

This would yield a 90% loss ratio. Then, to find the estimated adjustment, you would divide the loss ratio of 90%/the TLR of 80%, which would yield +12.5%.

There is a lot more that goes into calculating a renewal, especially when it comes to larger groups. For illustration purposes, we didn’t take into account a few other factors, such as trend (inflation) and reserves (claims lag). But the above, in a nutshell, is essentially how renewals are calculated. It’s a quick and easy way for a plan administrator to do the math to see where their group should stand.


How is the TLR determined?

You might ask: How is the TLR determined? Usually, it’s determined at the time of inception and illustrated on the initial quote. Included in the TLR calculation are the insurance company’s costs in handling servicing and claims adjudication, as well as any commission paid to the broker. As the group size grows, typically the TLR will increase and the administration cost will be lower relative to the amount of premium the insurance carrier is receiving.

So, the lower the TLR, the greater the portion of your premium going into expenses and administration and commissions.

You want to ensure that your TLR is updated accordingly and is negotiated to be as high as possible. And you can do this by working with specialized employee benefits brokers that have preferred pooling arrangements.

If you would like to have an in-depth discussion about understanding your renewals, please feel welcome to contact me with any questions.

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Am I already covered for travel insurance if I have employee benefits?


99% of the time the answer is YES, you are covered for travel MEDICAL insurance.

Most, if not all, group employee benefit plans have some kind of out of country coverage for unexpected medical emergencies. For example, if you slip and break your leg in Mexico, get food poisoning in Asia, or simply visit a local clinic for a fever, all such instances would be covered.

However, things like trip cancellation or lost luggage insurance are NOT covered under the majority of plans.

Unlike individual travel insurance policies, you do not have to inform the insurance company of your travel dates, as you are covered right away when you leave Canada. Unless there is an active travel advisory or special circumstances deeming a place to be dangerous, travel to most countries is covered.

Most plans provide coverage for at least 60 days continuous travel, but the duration resets when you return to Canada. Most plans cover up to $5M per insured person, which should be sufficient, but review your policy to make sure it fits your needs.

If you would like to find out more, feel free to contact us at Immix Group, where we specialize in employee benefits!

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BC’s Medical Services Plan: What is MSP – and what does it have to do with your benefits plan?

This blog is from 2017, and due to legislative changes in BC, MSP employer payments were cancelled.  Please read more here: https://www2.gov.bc.ca/gov/content/health/health-drug-coverage/msp/bc-residents/premiums


The three certainties that come along with living in British Columbia: death, taxes – and Medical Services Plan (MSP) premium increases.

Prior to joining Immix and entering the world of employee benefits, I shared the common misconception that the employer always pays MSP. I had worked for large companies and with the BC government in a union environment; in both job settings, my employer paid my MSP premiums as a part of the benefits package.

When I received my first MSP invoice with months of back charges, I had a rude awakening!

Now that I’m an Employee Benefits Account Executive with Immix, I get asked almost weekly what MSP covers and who should pay for it. With this article, my aim is to give you a brief overview of provincial health care – and how it relates to employer-sponsored benefit plans.

What is MSP?

MSP provides basic coverage and access to medically necessary health services in BC: doctor/hospital visits, emergency dental/oral surgery performed in the hospital, and some diagnostic services such as X-rays and eye exams.

Each province across Canada has its own version of provincial health care. The way each province bills health care varies.

Who pays for MSP?

MSP premiums are the responsibility of each individual/family, unless they’re lucky enough to have an employer who covers some or all of the cost. From my many years of experience in the benefits industry, many large corporations and unions will generally cover MSP costs, or have some sort of cost-sharing arrangement in place.

Smaller companies usually do not cover the cost of MSP premiums. However, that is not to say they can’t. Coverage is at the company’s discretion and is a generous perk. If an employer does pay provincial health care insurance premiums on its employees’ behalf, those premiums are considered to be a taxable benefit to the employee.

MSP premiums are based on an individual’s Adjusted Net Income. Effective January 1, 2017, minors and dependents enrolled in full-time postsecondary studies are no longer subject to MSP premiums.

As of January 1, 2017, the government further segmented income brackets to reduce the premiums for lower-income levels. For example, someone earning $30,000+ in 2016 (the highest-income bracket prior to 2017) was paying $75 per month in MSP premiums. In 2017, that same person earning $30,000 now pays $46 per month. The highest-income bracket has been increased to $42,000. Low-income individuals and seniors over age 65 may be eligible for premium assistance.

Premium Assistance- You might be eligible for a discount!

From personal experience, I highly recommend that anyone with senior parents or grandparents double-check to ensure they are receiving premium assistance, that is, lower monthly MSP premiums. MSP does not prompt them to do so – as my 88-year-old grandmother and I learned the hard way.

My grandma was paying way too much in MSP contributions. From my career in benefits, I recognized this – but MSP didn’t cooperate easily. We had to show them seven years of tax returns to prove her earnings! Only then, finally, did they backdate her significantly lower premium amount and refund those seven years of overpayment.

If we hadn’t taken the initiative, my grandma would still be overpaying to this day. So remember: MSP is quick to increase your monthly premiums when your income increases. But they don’t bother to reach out if you qualify for premium assistance. It’s up to each individual to apply for MSP premium assistance.

Here’s information on current premiums.

Do I need to have MSP?

The short answer is yes. British Columbia requires its residents to have MSP. In certain circumstances, adults can opt out of MSP, but this is very unusual. MSP covers access to physicians, hospitals and other services, regardless if care is needed for an emergency or non-emergency situation.

Employer-sponsored health coverage is additional coverage above and beyond MSP. The two types of coverage work in a complementary way, meaning an extended health insurance contract will not cover items paid for through MSP. Extended health care covers some or all of the cost of prescription drugs, medical equipment, health practitioner visits, etc. Without a group benefits plan, individuals are responsible for 100% of the cost of most health-care-related expenses not covered under MSP.

You need MSP to enrol in an employer-sponsored group health care plan. If you opt out of MSP, or become ineligible for other reasons, you won’t be able to enrol in the extended health care portion of the employer’s group benefits plan. (Note: dental will still be covered through group plans.) As well, you may not be able to purchase emergency travel insurance for trips outside the province.

The future of MSP…?

As noted earlier, provincial health care coverage varies by province; how the premiums are paid varies, as well. BC is the only province that charges a premium directly to individuals. Many other provinces have implemented a payroll tax or income tax charge to account for provincial health care premiums.

There has been a lot of talk in the media about the restructuring of MSP in BC. Minority political parties keep voicing their desire to change the way provincial health care premiums are collected. Generally speaking, the current administrative pricing arrangement is very unpopular with both individuals and the employers who administer the premiums for their employees.

The current BC government recently announced that as a part of BC’s plan to eliminate MSP premiums, they plan to cut premiums in half for individuals with an annual household net income under $120,000 effective January 1st, 2018. 

We’ll be sure to keep you posted on that and any other MSP developments.

Further reading 


At Immix, our role goes far beyond the pricing of your program.


From time to time, we are approached by businesses that do not have an employee benefits program in place. Or, they have a plan, but they do not have an active relationship with their benefits broker. Surprisingly to us, they sometimes don’t know their broker at all!

At Immix, our relationship with our clients is very different. Unlike many brokers, our role as your benefits broker goes far beyond pricing. We like to say that we consider ourselves an extension of your HR Department- and your partner- in managing your benefits program.

In this article, I will give some insight into how Immix adds significant value for our clients with the support we provide.


Experience and advice

What are other employers like us doing for their employees
We are asked this every day! Firstly, we know what’s happening out there in the benefits marketplace. That’s because benefits are our focus at Immix: all day, every day. We not only have access to industry information, reporting and benchmarking tools; we have in-depth experience and solid relationships that keep us on the pulse of our industry. This means we know what you need to do to be competitive when it comes to your benefits offering.

In short, we are the experts, so you don’t have to be.


Financial expertise & transparency

I don’t understand my benefits plan pricing, can you explain it to me? 

Unfortunately, when people think of a benefits broker they, might just think of the messenger who delivers rate increases year after year. At Immix Group, we are not just handing over the pricing as set by the insurance company.

Because of the volume of clients with whom we work, our role is not limited to presenting you with the renewal document and pricing as determined by the insurance carrier. We are intricately involved in setting our own pricing and negotiating fair and sustainable rates. We want to ensure that you understand how the demographics, usage and other factors impact the pricing of the plan.

Some of our clients want to know all the details, and other are happy just