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Category: Employee Health

What BC Employers Need to Know About Canada’s New Government Health Care Changes

Posted on by Immix Group

At the Immix Group, every government announcement on healthcare changes sparks the same question from plan sponsors: “Will this shift claims away from our group benefits plan and reduce claim costs?”

 

by Lindsay Byrka, CFP® Vice President, Immix Group

Canada is known for universal healthcare, but each province and territory administers its own plan. While medically necessary hospital and physician services are covered nationwide, provinces decide eligibility and additional coverage. Coverage is based on residency and is portable within Canada. Funding comes from the federal government via the Canada Health Transfer.

For example, eye exam coverage for children varies: most provinces cover it, but a few leave the cost to private plans or individuals. So, while healthcare is universal, coverage differences exist, and some services remain the responsibility of private insurance or individuals.

Government coverage updates often attract media attention, and employers may assume this reduces the role of group benefits. Historically, shifts have gone both ways, but recent changes have increasingly shifted coverage back to the government.

Loosely, the Canada Health Act prohibits coverage or services for items already covered by public healthcare to avoid a two-tiered system. Group benefits plans and their offerings fall under ‘private insurance.’  Generally speaking, the plans are complementary – insurers do not need to cover and cannot cover these items.

This article walks through significant recent changes, provides an overview of these changes, their potential impact on employee benefits programs, and what employers need to know.

Canada Dental Care Plan (CDCP)

The Canadian Dental Care Plan (CDCP) launched the end of 2023. After some initial hiccups mostly centered around the hesitancy of dentists to sign up due to unclear terms and conditions surrounding claims reimbursement, these issues appear to have been worked out. Reportedly 98% of dentists now care for patients under the CDCP. With the latest expansion, nearly 5M Canadians now have approved applications. The program is adjudicated by SunLife Financial.

 

Does the Federal Canadian Dental Care Plan replace coverage through an employer-sponsored group benefits plan?

No. To qualify, you must have no access to any coverage including a private plan, employer’s plan or through a Health Spending Account. This program is designed for lower income individuals and families without access to coverage.

 

Could an employer terminate their dental coverage in order to shift this expense to the government?

The likely effect would be very few eligible employees, and coverage would be far less than under a typical group benefits program. The CDCP provides limited coverage, to a limited segment of people, based on family income:

  • 40% coverage for family income at $80-$90K
  • 60% coverage for family income at $70-$80K
  • 100% coverage for family income under $70K

As indicated, there is coinsurance, and additional fees may be required. Coverage is limited to certain items, most of which are basic services attached to preventative oral care. Higher cost items including crowns require preapproval and may or may not be covered. More costly items like dental implants are not included.

 

Employer Requirement to Report Dental Care Eligibility on T4s

Beginning for 2023, employers were required to indicate one of five codes in a new Box 45 on T4 Slips, indicating status as of December 31 of the tax year: 

    1. No access to any dental coverage
    2. Coverage for the employee only
    3. Coverage for employee, spouse, and dependents
    4. Coverage for employee and spouse only
    5. Coverage for employee and dependents only

This caused a lot of confusion initially, and at the Immix Group we answered many questions as to the notations, especially surrounding the timing. This is now a requirement each tax year.

 

What is the Impact of the Canada Dental Care Plan on Employee Benefits Programs? 

In short, the rollout of the Federal Dental Program has not had a notable impact on employer programs. Within our block of business, no changes were made to any plans due to the CDCP. The biggest impacts on dental costs to employers remain the same: higher costs charged by dentists (inflation, advances in technology etc), an aging population and workforce with higher needs, and greater adherence to a routine visitation schedule.

National Pharmacare Initiative: Continued Expansion

What is Bill C-64 and why should it matter to Employers?

We’ve received a lot of questions about the new Pharmacare plan, and whether this will mean a reduction in employer extended health care costs. Bill C-64 is a step towards a national universal pharmacare (i.e. drug coverage). In short, it authorized the federal government’s funding (via the provinces/ territories) to provide coverage for prescription contraceptives, hormone replacement therapy and diabetes medication and supplies.

The long-term goal is to achieve universal, single-payer coverage for a wider range of prescription medication. A national pharmacare program could help ensure that all Canadians have access to the medications they need, regardless of their income or where they live. The initial focus is on providing these medications free or at low cost, eliminating the need to coordinate with private insurance plans for these specific items. Several areas have recently been addressed which have received a lot of attention.

Prescription Birth Control and Hormone Replacement Therapy

 

Does government coverage for contraception and hormone replacement therapy medications replace employer-sponsored coverage?

As coverage is rolled out region by region, yes, it should mostly cover medications previously covered via employer group benefits plans.

Since April 2023 in BC, prescription birth control has been covered at the point of service, nearly eliminating the need for private reimbursement. There are a few medications that may not be covered, but generally, this was a broad change. Other provinces are now phasing in similar coverage as part of the pharmacare framework. Because BC already rolled out coverage for prescription contraceptives, the new funding will be directed towards hormone replacement therapy (HRT) in BC.

 

What is the Impact on Group Benefits Plans and Employers of Government Funded Prescription Birth Control:
Employers do not need to take action to remove specific drugs from their plans. As governments roll out these changes (as we already saw in BC), insurance carriers will adapt their coverage, ensuring private and group benefits programs no longer cover these items.

Financially, the effect may be minor—contraception and HRT tends to be lower-cost in the overall drug landscape, but this will differ depending on the demographics of your group.  

 

Family Planning and Fertility Benefits

While the Federal government has indicated the intent to expand coverage related to “fertility care, reproductive health, and family-building support” current coverage is via the provinces and territories and differs significantly.

As of July 2, 2025, for eligible applicants, BC funds one standard IVF cycle for ages 18-41. This new government coverage is income tested, looking to household income, and providing the maximum following benefits, for one IVF cycle and related medications:

  • Under $100K, $19K
  • $100K-$150K, $14,250
  • $150K-$200K, $9,500
  • $200K to $250K, $4,750

Over $250K of family income, no coverage is available via the BC government. It’s worth noting there are other common family-building/ fertility expenses beyond IVF such as egg / sperm freezing, IUI, and more, which remain outside the scope of government coverage.

 

What does the new BC IVF coverage this mean for employers and their group benefits plans?

At this point, not a lot. While it’s a small win for families who have struggled to conceive and the new government coverage in BC is a step in the right direction, this doesn’t mean much for employer cost shifting.  Most benefits programs offer very limited or no coverage at all for expenses related to fertility treatments. If some coverage is in place, it’s inadequate compared to actual costs for full circle fertility treatments such as In-Vitro Fertilization.

As the actual costs typically far exceed the combination of government and any available employer coverage, this is still an area where we feel most people will experience a large financial gap in coverage.

Diabetes Medications & Devices

The new Federal pharmacare initiative has also authorized coverage for eligible diabetes medication and supplies. This is being rolled out at different times, depending on the province or territory. Many provinces have signed agreements and some were in effect for mid 2025 (Manitoba, PEI). As of August 2025, some agreements are still pending, while Alberta has indicated they will opt out.  

For British Columbia, the expected timeline is:

  • Starting March 1, 2026: 100% public coverage for eligible diabetes medications (for both Type 1 and Type 2 diabetes)
  • Starting April 1, 2026: Expanded coverage for diabetes devices and supplies, including items such as glucose monitors and test strips.

Similar to what we already saw with prescription contraceptives, it’s expected costs will be covered at point of sale without copay or deductible.

 

Does the federal pharmacare agreement relating to diabetes treatments replace coverage through an employer-sponsored group benefits plan?

We expect to see a reduction in diabetes related expenses on employer plans. Diabetes medications represent roughly 15% of drug plan spending by dollars, largely driven by rising demand and the adoption of higher-cost therapies. With pharmacare coverage rolling out, employers may benefit from reduced claims for this therapeutic category.

Again, exact covered drugs and supplies will differ by province. While core medications like insulin and metformin will certainly be included, it is not yet clear whether newer, higher-cost therapies (such as GLP-1s like Ozempic and Trulicity) will be covered in full, and the extent or timing of coverage for supplies like insulin pumps, blood glucose monitors and test strips, per region.

 

Do Employers need to make changes to benefits plans due to the roll out of government coverage for diabetes treatments?  

As we saw with prescription birth control, insurance carriers will adjust eligible drugs under employer group benefits plans to coordinate with changes in provincial coverage, as these changes roll out. Employers and advisors will not need to take on the task of ensuring no duplication of coverage.

Service Canada Employment Insurance Extension for Sickness Benefits  

What change was made to Service Canada EI Sickness Benefits?

Service Canada expanded the benefit duration for EI Sickness benefits to 26 weeks effective for December 18th 2022. Previously, coverage was 15 weeks after a 2-week waiting period (17 weeks total).

 

Why does the change to EI Sickness Benefits duration have a potential impact on employer sponsored group benefits programs?

This is because of the alignment of benefit timing. Long Term Disability coverage is typically provided through group benefits programs, and LTD has traditionally aligned with the end of the old EI Sickness benefit duration, commencing after 119 days (i.e 17 weeks).

It is worth noting that insured STD is not very common with SMBs. Less than half offer this, and coverage is more common with larger employers. Most smaller companies rely on EI Sickness for this pre-LTD period.

 

Do Employers need to adjust Long Term Disability plan waiting periods due to the change to EI Sickness Benefits?

Shifting to a longer waiting period has not made sense in most instances. Under a properly set up LTD plan, LTD should pay a great percentage of income replacement and an overall higher amount of benefit per month than under EI Sickness, which is limited to 55% of weekly earnings, to a max of $695 taxable (2025). LTD is usually 67% of pre-tax earnings, to a maximum, most commonly received tax free due to employee-paid premiums.

The premium reduction offered by insurance carriers to extend the group LTD waiting period from the usual 119 days to 182 days is very minor (2-3%), meaning it was overall more beneficial to have disabled plan members move more quickly to Long Term Disability.

At the Immix Group, across our block of business, we did not see employers make the switch to a longer group Long Term Disability elimination period. While we have established new group benefit plans since this time with 6-month LTD waiting periods, and these groups are usually smaller and with average incomes on the lower end.

 

Awareness and Communication is Key

Recent government health care changes are a positive step toward expanding access, and employers may see some costs shift away from their plans, potentially reducing claim expenses. Coverage varies by province and income level, so employers should stay aware of changes in their region. Generally, employers don’t need to amend their benefit plans; the key is staying informed—understanding how new programs work, how eligibility is determined, and how these changes interact with group benefits. Staying up to date helps employers maintain strong, competitive programs.

 

 

Key Takeaways

Employee benefit plans still essential – Government programs add safety nets but don’t replace group benefits. Expansions to government coverage will reduce some costs for some employers.

Dental plan impact minimal – CDCP is only for those without private coverage or access to coverage; employers must now report dental access on T4s.

Expanded Pharmacare rollout – Contraceptives, HRT, and diabetes drugs/devices are shifting to public coverage region by region; insurers will adjust automatically.

IVF coverage in BC – While federal coverage is still in the works, BC now funds one income-tested IVF cycle. However, due to the high costs and since most benefits plans offer little or no fertility coverage, the result is expected to be a minimal impact on employer plans.

EI sickness extension – Benefits extended to 26 weeks, but most employers haven’t changed LTD plans since LTD remains stronger.

Awareness is key – No major plan changes needed; employers should focus on communicating what new coverage means for employees.

FAQ’s

Does the Canadian Dental Care Plan replace employer dental coverage?
No. It only covers those without private or employer-sponsored dental coverage, and provides limited benefits based on income.

Do employers need to change their benefit plans because of expanded national Pharmacare coverage?
No. Insurers will automatically adjust plans as coverage rolls out for contraceptives, HRT, and diabetes medications/devices.

What does BC’s new IVF coverage mean for employers?
BC now funds one IVF cycle, with income-tested eligibility. However, costs usually exceed government support or traditional coverage under benefits plans, so there is minimal impact on employer plans.

Can employers expect cost savings from these government changes?
Potentially. Some costs may shift from employer plans to government programs, which could reduce claim expenses.

Read More

Canadian Dental Care Plan – Dental Benefits Guide – Canada.ca

National pharmacare in B.C. – Province of British Columbia

Universal Access to Contraception and Diabetes Medications and Increased Access to Diabetes Devices and Supplies, Canada-British Columbia Funding Agreement – Canada.ca

Free contraceptives – Province of British Columbia

Government of Canada improves sickness benefits under the Employment Insurance system – Canada.ca

EI Sickness Benefit – How much you could receive – Canada.ca

Canadian Dental Care Plan – Do you qualify – Canada.ca

Federal Funding – Canadian Fertility & Andrology Society

Publicly funded in-vitro fertilization (IVF) program – Province of British Columbia

Supporting Women at Every Stage: How Employee Benefits Can Make a Difference – Latest News from Immix Group

Dental Care Measures Act – T4 and T4A Updates – Canada.ca

Lindsay Byrka

Lindsay Byrka, CFP® BA, BEd

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

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Unmasking Mental Health: From Awareness to Action

Posted on by Immix Group

by Lindsay Byrka | B.A., B.Ed, CFP | Vice President

Mental Health Awareness Week in Canada takes place the first full week of May. This year’s theme—Unmasking Mental Health— is a reminder that behind every desk are real people with real challenges, struggles, and emotions—often not visible or obvious to those around them.

As described by the Canadian Mental Health Association, many who live with mental health challenges hide behind a ‘mask’ in order to protect themselves from judgement and discrimination. This is a heavy burden to bear.

There’s No One-Size-Fits-All—For Benefits or for People

At the Immix Group, we often say, “No two companies are the same—so why should their employee benefits programs be the same?” This belief extends to mental health support as well. Every organization is unique. That means their approach to mental health and wellness must be too.

As an independent employee benefits consulting firm based in Vancouver, we’ve seen the value of proactive planning. Resilient companies don’t just react—they design their programs to prevent issues before they escalate, and that starts by tailoring your plan to fit your people.

A Thoughtful Plan Design with Comprehensive Mental Health Supports

While we recognize that there is more to a healthy workplace than the benefits offering, this is the area where the Immix Group provides our expertise. At the Immix Group, we work with organizations to build custom employee benefits packages that include proactive and preventative offerings including:

  • Flexible benefits that allow employees the autonomy to direct dollars to where they are most needed
  • Ongoing employee wellness initiatives; access to varied resources, webinars, specialized practitioners and more
  • Enhanced offerings for mental health practitioners that include a full range of providers
  • Access to mental health resources including the many resources contained within robust Employee & Family Assistance Programs
  • Methods and funding to support physical activity and social connection
  • Financial well-being through group savings programs and financial literacy education opportunities
  • Clear and compassionate return-to-work pathways

The best prevention is a plan rooted in your culture, values, and people. These supports might not always be visible—but their impact is.

Start with Clear, Consistent and Open Communication

It is essential to clearly communicate the many mental health resources available to members through the various elements of their benefits offering. Many people are simply unaware of the supports that exist. Simply reminding and assisting employees with accessing the resources available to them goes a long way.  

Additionally, creating a safe environment starts with open communication. Encourage employees to share concerns early and reach out for support; that simple shift can mean the difference between a short-term challenge and a long-term leave.

Mental Health Claims Make up over a Third of Disability Claims

However, despite the best efforts of organizations to offer support to employees, disability claims will inevitably occur. Mental health now accounts for over one-third of disability claims in Canada, with conditions like anxiety, depression, and stress-related disorders among the top causes of both short- and long-term absences.

In short, mental illnesses are medical conditions that can affect people in many ways—impacting thought processes, emotions, behaviours, sense of self, relationships, and the ability to cope with stress. These challenges can, in turn, influence a person’s capacity to work and engage socially. (Government of Canada, 2023).

Even if a claim begins as physical, mental health concerns can become part of the picture over time. While these claims can be complex, the good news is that carriers and providers have made significant strides in how they approach mental health claims.

Early Intervention is Key

The statistics are clear: the first 30-60 days of a leave are a pivotal window. Prolonged silence or disconnection can complicate recovery, deepen isolation, and extend absences.

Whether through HR, managers, or a disability support partner, reaching out isn’t just a formality—it’s a signal of care. It keeps the door open for return and reduces the mental health strain of feeling “out of sight, out of mind.” Key strategies to support recovery from day one:

  • Maintain consistent, supportive and appropriate communication—don’t go silent
  • Build confidence in the disability management process with clear plans and shared understanding
  • Help employees feel tethered to their purpose, team, and workplace

The goal is to help employees on leave feel engaged. Once disengagement sets in, recovery becomes harder—for the employee and the organization.

The Cost of a Disengaged Leave

According to Service Canada, extended leave can cause employees to lose their sense of structure, identity, and connection. From a business standpoint, the cost is also significant—emotionally (for example, the impact on coworkers) and financially (lost productivity, hiring and training a replacement).

Industry data shows that after 6 months on leave, the chance of an employee returning to work drops to 20%. After 11 months, it drops to just 2%. In short, the longer someone is off work, the less likely they are to return. 

Let’s be clear: the goal is not to rush anyone back to work who is not medically ready. Employees who meet the definition of disability are rightfully entitled to benefits. But it’s essential to balance recovery with strategic engagement—so when they are ready, they feel connected and the path back is clear.

Plan Proactively: Support Your People and Your Organization

For the small and mid-sized businesses with whom we work, while they may not have a robust HR department, they can still implement a basic checklist of touch points to ensure connection is maintained. And they can work with our team at the Immix Group for guidance every step of the way.  

For larger organizations, it may make sense to partner with a speciality provider in this area, and to implement a formal Early Intervention Program (EIP). A provider with whom the Immix Group works is Acclaim Ability Management . Organizations like Acclaim make a measurable difference. Their specialized services include:

  • Early clinical intervention
  • Mental health triage and support
  • Guided communication strategies between employer and employee
  • Coordinated return-to-work planning

Companies like Acclaim don’t just manage claims—they manage the experience, from the first day of leave to the first day back. Their support ensures the process is human, effective, and efficient.

Return to Work with Support and Compassion

Research shows that returning to work as soon as possible—when medically appropriate—can support faster recovery and improve overall well-being. Benefits of an early, supported return include:

  • Aiding rehabilitation and mental health recovery
  • Preserving income and independence
  • Reducing long-term incapacity and isolation
  • Strengthening confidence and self-worth

For employers, it’s important to communicate clear expectations and be ready to offer modified duties and timelines. Having the employee come back under a modified return-to-work plan can greatly improve their chances of returning to their pre-disability functions.

Engagement Matters at Every Stage

To sum it up, support shouldn’t start at diagnosis or when an employee takes leave, and it shouldn’t end when someone returns to work. True support and engagement means:

  • Aligning your benefit offerings with your values
  • Regularly sharing resources and mental health supports
  • Creating a culture where asking for help is safe
  • Maintaining connection through leave and reintegration

When employees know your support is real, they feel seen, supported, and secure.

More Than Just a Benefits Program

At the Immix Group, we design benefits programs that do more than check a box. We build plans that connect, protect, and reflect your people. Because when your people feel supported, your business is too.

Curious to know if your employee benefits program is aligned with your organization’s unique needs? Email info@immixgroup.ca today or call (604) 688-5559 to speak with an Immix team member today; we love to hear from you!

Top 8 FAQ’s

The theme is Unmasking Mental Health—a reminder that behind every desk are real people with real challenges, struggles, and emotions.

Because no two companies—or their people—are the same. A tailored approach ensures your plan actually fits your team and their needs.

Proactive supports include flexible benefits, wellness initiatives, enhanced mental health practitioner access, EFAP resources, funding for physical/social activity, and financial literacy education.

Many employees are unaware of available resources. Open, consistent communication helps ensure supports are actually used—and that people feel safe asking for help.

Mental health conditions now account for over one-third of disability claims in Canada, with anxiety, depression, and stress-related disorders being top causes.

The first 30–60 days are critical; staying connected shows care, prevents isolation, and helps pave the way for a successful return.



The longer someone is off, the less likely they are to return. After six months, return-to-work chances drop to 20%; after eleven months, just 2%.

With clear expectations, modified duties, and compassionate communication. Support that begins early makes all the difference in recovery and reintegration.

Top 5 key takeaways:

  • Mental health support should reflect your company culture. A plan rooted in your organization’s values and people—not just policy—drives real results.
  • Employee engagement begins before a leave and continues through reintegration. True support spans the full recovery journey, not just the crisis moment.
  • Small and mid-sized businesses can still implement effective mental health strategies. Even without large HR teams, consistent check-ins and partnering with experts like ourselves, the Immix Group, makes a difference.
  • Carriers and providers are evolving in their approach to mental health. Claims may be complex, but modern tools and strategies make them more manageable and human-centered.
  • Mental health is both a human and business priority. The emotional and financial cost of disengagement is high—but preventable with thoughtful planning.

Read More

How Disability Management Fast-tracks Employee Health & Return to Work            

Early Intervention and Return to Work Program for supervisors – Province of British Columbia

Support for Recovery – Canada.ca

Acclaim Ability Management

Canadian Mental Health Association

Lindsay Byrka

Lindsay Byrka, CFP® BA, BEd

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

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Your Benefits, Your Way: The “101” on Health & Wellness Spending Accounts

Posted on by Immix Group

by Lindsay Byrka | B.A., B.Ed, CFP | Vice President

If you’re a Canadian business owner looking to offer flexible, tax-effective coverage that empowers your team, an HSA could be the missing piece of your benefits offering.

In this guide, we’ll break down what an HSA is, how it works, and why businesses like yours are making it a staple in their employee benefits package.

Health and Wellness Spending Accounts are Increasing in Popularity

Most people have heard of Health Spending Accounts, which have become increasingly popular over the past decade or so, with around 40% of plans offering some form of HSA.

This is in response to multiple generations in the Canadian workforce and their diverse needs, the increasing desire for flexibility and choice, and the simplicity of offering this predictable-cost benefit.

Most Canadian carriers now facilitate not only Health Spending Accounts (non-taxable, for items on the CRA’s Eligible Medical Expense listing) but also Wellness or Lifestyle Spending Accounts (taxable items that fall outside the CRA listing). In addition, many specialty providers offer robust, low-cost, user-friendly platforms for Health and Wellness Spending Accounts with many customizations available.

What is a Health Spending Account? 

A Health Spending Account is set up by an Employer and provides a pre-determined annual allocation to an Employee, to be used for CRA-eligible medical expenses. Employees have the flexibility to choose which expenses are submitted through the Health Spending Account. Employees receive reimbursement for eligible claims on a tax-free basis. As the Employee uses their account, their available balance reduces.

Employers pay for the amount of the expense, plus an administrative charge for adjudication, and any applicable taxes on the admin fee. The total expense is tax-deductible to the Employer. To be CRA-compliant, Health Spending Accounts need to be facilitated via a third-party provider.

What is a Wellness Spending Account (WSA)?

Also known as a Lifestyle Spending Account (LSA), the primary difference from a Health Spending Account is WSAs/ LSAs are for taxable expenses (i.e. those not found under the CRA listing). The funding and cost for the Employers are the same as with a HSA, and Employers can also deduct the expense. The main difference is that expenses reimbursed through a Wellness/ Lifestyle Spending Account are a taxable benefit to Employees.

What is a Flexible Spending Account?

This simply refers to an account where the employee has both HSA and WSA reimbursement available. Typically, they can choose what percentage of the total allocation falls into each of the buckets (taxable or non-taxable) as described.

health spending account vs. wellness spending account Canada chart by Immix Group

Collectively, many people refer to these accounts as “Health Spending Accounts” or “Health Care Spending Accounts” or by the American term “Health Savings Accounts,” although they may offer the ability to remit expenses under each tax bucket.

The Benefits: Why More Employers are Implementing Health Spending Accounts

From our perspective as benefits advisors, the answer to this is twofold: employees love Health Spending Accounts for the flexibility and choice, and employers find them cost-effective, simple and practical. The benefits are vast:

  • Provides employees with choice and flexibility as to how benefit dollars are spent.
  • Supplements insured benefits program reimbursement for example topping up an insured benefit item where a dollar limit has been reached.
  • Cost control for employers; there is an upper limit per year and a defined admin fee, so no surprises!
  • Ability to highly customize including with classes of coverage with varying levels of allocation.
  • High value to invest in wellness programs, with research indicating 300-400% ROI.
  • Tax advantaged as a fully deductible expense for employers.

What sorts of items can be covered through a Health Spending Account?

HSAs can cover a wide range of expenses as determined by the CRA Eligible Medical Expense Listing similar to traditional health benefits, including:

  • Dental treatments and orthodontics
  • Prescription drugs and medical devices
  • Paramedical services like massage therapy, physiotherapy, and acupuncture
  • Vision care, including glasses and laser eye surgery
  • Medical equipment, supplies or surgeries
  • Mental health practitioners
  • Insurance premiums, deductibles and coinsurance from insured plans

Wellness Spending Accounts can cover nearly anything the employer desires! Common expenses include:

  • Gym memberships, fitness classes
  • Activity passes such as ski passes
  • Children’s sports
  • Childcare expenses
  • Vitamins and supplements
  • Fitness equipment
  • Contributions to RRSPs
  • Medical practitioners excluded by the CRA such as alternative health practitioners

Health Spending Accounts vs. Traditional Insured Benefits

At the Immix Group, we firmly believe that Health & Wellness Spending Accounts should be considered as a supplement to a more robust insurance program that offers coverage for prescription drugs, emergency out-of-country travel, dental, and other more catastrophic insurance coverage such as life, critical illness and disability.

With the defined dollar limit provided via a Health Spending Account, it works best as a supplement to provide flexibility and choice to a base insurance plan. In short:

Traditional Insured Plans:

  • Pre-defined coverage with limits on certain services but typically covers catastrophic expenses at first dollar.
  • Best for drugs, travel, disability, and items where true “insurance” is needed to guard against the unknown.

Health & Wellness Spending Accounts:

  • Top-up insured programs where limits are in place, or cover un-insured items.
  • Flexible spending based on individual needs.
  • Allow reimbursement for wellness and lifestyle expenses not included through traditional insured benefits programs.

Key Features: With a Health Spending Account you can:

  • Implement classes with different allocations available for different employee classifications.
  • Allow one-year carry forward of unused balances (one year only, per CRA).
  • Implement coinsurance (i.e. 50% reimbursement up to a total limit).
  • Define the items covered within a Wellness Spending Account.
  • Implement dedicated accounts to target specific areas (i.e. PPE account, Mental Health account, Childcare account).
  • Easily pull reporting for tax purposes.
  • Make changes to the allocation you provide at the start of each year.

A Predictable, Low-Cost Benefit for Employers

One of the main reasons employers are drawn to Health Spending Accounts is the cost predictability and transparency.  

  • Low administration cost, usually ranging from 3-10% on submitted expenses (plus applicable taxes on the admin charge only).
  • Ability to change the offering each year, to adjust to budget constraints.
  • Ability to implement ‘use it or lose’ rather than the ability to carry forward unused balances in order to have even greater cost predictability in a given period.

On average, employees typically spend around 60-70% of their allocated amount, making this a good estimate for employers looking to budget. Ultimately, the ‘worst case scenario’ (or best case scenario, depending on how you think about it!) is that all employees use 100% of their allocation.

A Hidden Perk: The Tax Advantage

Health & Wellness Spending Accounts aren’t just flexible — they’re smart.

  • For Employers: Contributions are 100% tax-deductible
  • For Employees: Reimbursements are tax-free for Health Spending Accounts

Although Wellness Spending Account reimbursements are a taxable benefit, most employees still see this as a huge perk as the cost of paying the tax on an expense is of course a small amount relative to paying out-of-pocket for the same item. For employers, providing funds via an HSA is less costly than the equivalent in salary.

HSA vs WSA

What kind of Employer should implement a Health Spending Account?

The short answer? Every size of business, even a one-person incorporated company. While we do believe in providing a base insurance program to ensure proper protection against major expenses, there is a place for a Health Spending Account whether you are a two-person tech start-up in Vancouver British Columbia or a larger, established employer in Ontario.

Implementing a Health Spending Account can be a game-changer for:

  • Small businesses that want flexible coverage and don’t yet have the budget for a traditional insured plan.
  • Growing teams looking to offer competitive benefits.
  • Companies with diverse needs where one-size-fits-all plans don’t cut it.
  • Companies that want to customize their offering through targeted Health Spending Accounts.

 

How to Set Up a Health and Wellness Spending Account

First, you can set up a Health Spending Account with either a dedicated specialty provider (such as myHSA) or as an add-on to your program with your insured benefits provider.  

An advantage of implementing a program with your insurance provider (for example Manulife, Sunlife, Pacific Blue Cross) is the ability to more seamlessly direct unpaid claim balances towards the Health Spending Account. However, insurance providers tend to be more costly and less flexible with account parameters.

Our preference is to work with a dedicated HSA provider.

HSA 9

Getting started is easier than you might think.

At the Immix Group, we help businesses build benefits plans that are clear, custom, and transparent — and that includes HSAs.

We help you to:

  • Set a Budget: Choose how much you’ll contribute per employee on an annual basis.
  • Establish Rules: Decide what expenses are eligible, and features such as whether to include the ability to carry forward unused balances, whether to allow employees to include expenses for dependents etc.
  • Communicate Clearly: Educate your team on how to use their HSA effectively, in conjunction with any other benefits programs in place.
  • Adjust as Need: Employees will submit expenses and be reimbursed, thereby reducing their available balance. The plan sponsor will have the ability to review the overall usage and make any changes to allocations or customizations, as needed (typically after the plan has been in place for one year).

 

Is an HSA Right for Your Business? Let’s Chat!

If you’re ready to explore how a Health & Wellness Spending Account can help you control costs while giving your team greater flexibility, we’re here to guide you. Reach out to us at info@immixgroup.ca or (604) 688-5559  – we love to hear from you!

Top 10 FAQs

An HSA is an employer-funded account that allows employees to be reimbursed for CRA-eligible medical expenses on a tax-free basis.

Employers allocate a set amount per year to employees, who then use it to cover eligible health expenses. Employers only pay for actual claims submitted, plus administrative fees.

A WSA (or LSA) covers taxable expenses such as gym memberships and wellness programs. Unlike an HSA, reimbursements are considered taxable income for employees.

While possible, HSAs are best used as a supplement to traditional benefits to provide more flexibility and customization.

Minimum amounts typically start at $250 per employee, with executive-level accounts often reaching tens of thousands per year.

Yes, all employer contributions to an HSA are 100% tax-deductible, making them a cost-effective way to provide benefits.

Employers can allow a one-year carry forward of unused balances, but beyond that, the funds expire as per CRA rules.

Any incorporated business can set up an HSA, including small businesses, self-employed individuals, and large companies. An HSA can be set up for just one person, but the business must be incorporated, and the individual must receive T4 income. Shareholders typically cannot participate.

Eligible expenses include dental treatments, prescription drugs, paramedical services, vision care, and medical equipment, among others.

Employers can set up an HSA through an insured benefits provider or a specialty provider, customizing rules and contribution levels as needed.

This restriction is due to compliance with CRA regulations, which require allocations to be determined in advance.

Key Takeaways

  1. HSAs Offer Flexibility & Choice
    Employees can use HSAs for a wide range of medical expenses based on their individual needs, making them more adaptable than traditional one-size-fits-all benefits plans.
  2. Cost Control & Predictability for Employers
    Employers can set defined contribution limits, ensuring there are no surprise costs. The ability to adjust annual allocations or enforce a “use-it-or-lose-it” policy adds further financial control.
  3. HSAs Are a Tax-Effective Way to Provide Benefits
    Contributions are fully tax-deductible for employers, and reimbursements are tax-free for employees—making HSAs a more cost-efficient alternative to salary increases.
  4. WSAs Can Boost Employee Engagement & Wellness
    By covering wellness-related expenses like fitness memberships, mental health services, and even childcare, WSAs help promote employee well-being and work-life balance.
  5. Combining HSAs & WSAs Maximizes Employee Satisfaction
    Offering both allows employees to balance healthcare needs with lifestyle benefits, increasing overall satisfaction and retention. Employers can customize coverage to align with company culture.
  6. Ideal for Small Businesses & Large Enterprises Alike
    HSAs and WSAs are scalable solutions, benefiting businesses of all sizes—from startups looking for an alternative to traditional insurance to large corporations adding customization to their benefits package.
  7. Implementation is Simple with the Right Provider
    Employers can integrate an HSA/WSA into their benefits program seamlessly through an insurer or third-party provider, with many offering user-friendly digital platforms for easy claims processing. Using a third party ensures compliance with tax regulations, simplifies administration, and helps maintain proper documentation for CRA purposes.

Read more

 

Lindsay Byrka

Lindsay Byrka, CFP® BA, BEd

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

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Latest Insights

Supporting Women at Every Stage: How Employee Benefits Can Make a Difference

Posted on by Immix Group

The Workplace Has Changed—Have Your Benefits?

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March 8th is International Women’s Day, described as a day to “recognize and celebrate the social, economic, cultural and political achievements of women and girls.” This year’s theme is “Accelerate Action.” With this in mind, we wanted to highlight how employers can take action to design thoughtful benefits programs that support women at every stage of life.  Please note, while these areas are not exclusive to women, they more commonly affect women, and are more accessed by women.

Women are a driving force in today’s workforce, yet too often, employee benefits have not evolved to meet women’s needs. From starting a family to navigating fertility treatments, returning to work, or managing perimenopause and menopause, the right support can make all the difference.

While we have come a long way from a time when prescription contraceptives were excluded under benefit programs to having these covered by the government, there is still a long way to go.

The good news, as we wrote in our latest Key Conversations in Benefits article, is that 2024 saw women’s health at the forefront of many conversations.

 

Family planning and fertility support  

Specifically, we are seeing insurance carriers address what they are calling ‘family planning’ benefits, which include coverage for: 

  • Fertility drugs
  • In Vitro Fertilization
  • Intra-uterine insemination
  • Egg freezing
  • Adoption fees
  • Surrogacy costs

One in six couples faces fertility challenges; quite simply, it’s a common medical situation where both men and women may need to take medication or undergo procedures. Unfortunately, financial support via a benefits program is typically lacking; treatments are costly and rarely covered.

Depending on the provider, these expenses may not even be an option for the plan sponsor to include. If available, the coverage often needs to be explicitly added.  Typically, where coverage for “fertility” is available, drugs related to fertility treatments have been covered, while procedure costs have been excluded. Most carriers include an annual or lifetime reimbursement limit that falls far short of average expenses.

We believe that fertility coverage should be included in all benefits programs as an embedded coverage line.  Companies that offer fertility coverage see higher employee satisfaction and reduced turnover—especially among higher-level professionals delaying parenthood due to career demands.

Taking it a step further than the financial element, progressive companies are providing support not only in the form of insurance coverage for related drugs and procedures but also in time off and flexibility for the medical procedures and health impacts that can accompany those undergoing fertility treatments.

The recent announcement by the BC government regarding the funding of IVF (one round) is positive news and will provide great support to those facing infertility. Related to this, the BC government has covered prescription birth control since April 2023. The federal government is seeking to do the same across Canada.

 

Maternity and parental leave benefits

Canada has a reputation for excellent support and federal protections for parents who wish to take maternity and parental leave with the birth or adoption of a child. Employment Insurance, however, provides just 55% of earnings to a maximum taxable weekly payment (the same as EI).

Depending on your family situation and the cost of living in your location, many families are unable to make ends meet with one parent receiving just EI payments.

It is worth noting that more and more men and non-birthing partners are taking parental leave (47% as of 2022), but it is still primarily mothers who are taking leave (for example, 94% of mothers vs 47% of their partners claimed or intended to claim parental benefits in 2022).

 

Top-up pay during maternity and parental leave

More progressive companies offer top-up pay to supplement Employment Insurance payments. There are many reasons for this, including supporting mental and financial wellness, attraction and retention, and organizational culture. While this can be costly, it is ultimately an investment in the employee.

There are many creative ways to structure this; there can be the requirement to return to work for a minimum duration (or owe back the funds), partial top-ups (i.e. an additional amount of pay, but not to full income), or top-up for a limited time (this is often aligned to the maternity/ medical portion of leave).

For employers, there is no requirement to register a top-up plan with the CRA as in the past (i.e. it will not claw back EI to pay top-up to an employee on parental leave).

Despite the many benefits of offering this support, only around 58% of companies provide some form of top-up program, and this is generally limited in duration and amount.

 

Continuity of benefits during parental leave

While off on leave, employees are still considered ‘active employees’ meaning they have the right to continue to participate in benefits programs.

Employers are required to keep employees on employer-paid benefits while on maternity or parental leave. Generally, if employees are paying a portion of the premiums, they are able to opt out of benefits and return without penalty when they are back at work (i.e. the waiting period or pre-existing conditions period would not apply to them). It is a common practice for employers to collect post-dated cheques in order to have employees continue to cover their share of the cost if there is no pay to deduct from.

Our recommendation is always for employees to try to keep their benefits intact while on leave, to continue to support health and well-being. We encourage employers to facilitate this the best they can.

 

Returning to work after children

According to Statistics Canada, only 66% of mothers return to full-time work after parental leave. Proactive support during this major life change can significantly boost employee satisfaction and loyalty. Companies with better parental benefits see higher retention and smoother transitions back to work. Flexibility goes a long way!

Offering new parents hybrid work options, flexible hours and flexible benefits, all play a role in supporting this time of life. For example, many parents struggle to find appropriate daycare; employers ultimately benefit from being understanding and flexible with timelines, while setting boundaries that work for both parties. Generally speaking, it is more advantageous in the long term to offer flexibility in support of an excellent employee, than force a situation that will result in them leaving their job.

Employers should also remind parents about the support offered within an Employee & Family Assistance Program. One of our own staff members here at the Immix Group found himself overwhelmed with the ‘terrible twos’ and found that the assistance offered via the EFAP was extremely beneficial!


Mid-life women – support during perimenopause and beyond

Women, 50% of the workforce, will experience menopause, yet only 1 in 5 Canadian companies have policies to support it. (Menopause Foundation of Canada, 2023)

In the years leading up to menopause (which is technically one day!) is peri-menopause, a long transition period where women’s bodies may experience a myriad of symptoms which can be quite debilitating. Leading benefits plans include:

  • Coverage for hormone therapy, medical consultations, and mental health support
  • Menopause-inclusive sick leave for severe symptoms
  • Workplace education programs to foster awareness

Ignoring peri-menopause and menopause in benefits planning can lead to absenteeism, productivity loss, and increased turnover among experienced employees.

One piece of good news is the government has announced funding for hormone replacement therapy (HRT) in BC beginning in April 2025, which can be very effective in assisting women in managing symptoms during this period.

 

Health & wellness spending accounts to offer flexibility and choice

At the Immix Group, we are strong believers in the value of Health & Wellness Spending Accounts, as a supplement to an insured benefit program.

In addition to medical expenses, a flex spending account can provide reimbursement for other “wellness or lifestyle” expenses, on a taxable basis. Families are supported with the ability to claim for childcare, children’s sports, doulas, lactation and sleep consultants, and a myriad of other related expenses that would not normally be reimbursable under a group extended healthcare program. Mid-life women can access products, medications and therapies to assist in relieving symptoms (CBT, weight training, supplements etc). A Health Spending Account also offers valuable dollars towards mental health practitioners, which are easily exhausted within a traditional benefits program.

 

Investing in Women’s Health is Investing in Your Workforce

Comprehensive benefits that address family planning, parental leave, mid-life health, and overall wellness can have a profound impact on employee satisfaction, retention, and productivity.

As we recognize International Women’s Day and this year’s theme of “Accelerate Action,” now is the time for employers to take a closer look at their benefits programs. Are they truly meeting the needs of today’s workforce? Thoughtful updates to parental leave policies, fertility benefits, and menopause support aren’t just perks—they’re essential to fostering an inclusive, high-performing workplace.

At the Immix Group, we believe that benefits should evolve alongside the people they serve. Interested in discussing how your organization can lead the way in supporting women’s health and well-being? Reach out to us at info@immixgroup.ca or (604) 688-5559  – we love to hear from you!

Top 8 FAQ’s

Women make up a significant portion of the workforce, yet traditional benefits have not always addressed their needs. Thoughtful coverage leads to higher employee satisfaction, retention, and overall well-being.

Some plans offer coverage for fertility drugs, IVF, IUI, egg freezing, adoption fees, and surrogacy costs. However, these are emerging benefits, often add-ons, and usually require employer selection.

Employers can supplement Employment Insurance (EI) payments with top-ups, which may cover a portion of the employee’s salary for a set period. This helps ease financial strain during leave.

Perimenopause and menopause can impact work performance, yet few companies provide coverage for hormone therapy, medical support, or flexible sick leave. Addressing this gap helps retain experienced employees.

These accounts allow employees to claim medical and wellness expenses beyond standard benefits, including for mental health, child care, and menopause-related therapies.

Yes, BC’s government recently announced funding for one round of IVF and hormone replacement therapy (HRT) starting in 2025, but workplace benefits remain crucial for ongoing support.

Offering flexible, customizable plans—including support for family planning, parental leave, and mid-life health—ensures benefits meet the needs of a diverse workforce.

Companies that proactively support women’s health see increased employee satisfaction, reduced absenteeism, stronger retention, and a more inclusive workplace culture.

7 Key Takeaways

  1. Women’s health is still underrepresented in employee benefits: While progress has been made, many benefits plans do not fully address key health challenges that disproportionately affect women, such as fertility treatments, parental leave financial support, and menopause-related health issues.
  2. Family planning benefits are becoming more common, but coverage is limited: Some employers now offer fertility coverage (for drugs, treatments, adoption, and surrogacy), but coverage caps often leave employees with significant out-of-pocket expenses. Companies that offer comprehensive fertility benefits see higher employee satisfaction and better retention rates.
  3. Returning to work after parental leave is a major transition: Only 66% of mothers return to full-time work after parental leave. Flexible work arrangements, hybrid options, and support resources can ease this transition, reducing employee turnover.
  4. Menopause support in the workplace is long overdue: Despite menopause affecting half the workforce, only 20% of companies offer support. Expanding benefits to include hormone therapy, mental health support, and menopause-friendly sick leave can improve employee well-being and productivity.
  5. Health & Wellness Spending Accounts provide much-needed flexibility: HSAs and WSAs allow employees to tailor benefits to their unique needs, covering costs for childcare, mental health support, menopause treatments, and more. These accounts are a cost-effective way for employers to enhance their benefits offering.
  6. Investing in women’s health is investing in your workforce: Companies that proactively expand benefits for family planning, maternity leave, menopause, and wellness foster a healthier, more engaged workforce. As workplaces evolve, benefits should too—supporting employees at every stage of life leads to better retention, morale, and long-term success.

Read More

Key Conversations in Benefits 2024 – Latest News from Immix Group

The HER-BC Report – Women’s Health Research Institute

Save the date for International Women’s Day 2025 events – Canada.ca

International Women’s Day 2025

Partners’ uptake of parental benefits: An upward trend?

Making the case for top-up plans | Canadian HR Reporter

Governments of Canada and British Columbia partner to improve contraception and diabetes coverage for residents – Canada.ca

Lindsay Byrka

Lindsay Byrka, CFP® BA, BEd

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

Latest Insights

Expanding into Canada

Posted on by Immix Group

Expanding into Canada? What Non-Canadian entities need to know when implementing an Employee Benefit program in Canada

Key Takeaways

  1. A typical employee benefits plan in Canada includes life insurance, extended health care, dental care, and often additional offerings like disability insurance, health spending accounts and retirement savings plans.
  2. The healthcare component of employee benefit programs is complementary to the coverage provided via provincial coverage, under Canada’s universal healthcare system.
  3. Navigating provincial regulations and employment standards is critical, making it important to work with licensed advisors who understand the Canadian market.
  4. Offering a robust benefits package is key to attracting and retaining skilled employees in Canada’s competitive job market.
  5. Customizing benefits to meet the specific needs of your Canadian workforce and industry will help ensure your company’s long-term success in Canada.

This year alone, the Immix Group, based out of Vancouver, British Columbia, has set up employee benefit programs for businesses head-officed in multiple countries around the world. Whether you’re in Australia, Singapore, Ireland, or the United States, there are key pieces of information to know if you are setting up a Canadian entity.

Companies are driven to expand into Canada by many factors including market opportunities, economic conditions, and strategic considerations. In particular, the highly educated, diverse workforce makes Canada an attractive location for companies, often at a lower cost than expansion to comparable locations.  

To be competitive and successful in this expansion, companies must consider providing the right set of employee benefits for their Canadian employees. And this involves understanding the legal requirements and offering the right benefits. Here’s a list of key things to help you navigate the process:

 

The Basics: Canada has a Universal Healthcare System

Canada has universal healthcare, which is adjudicated provincially; this means coverage differs slightly depending on the province or territory of residence of your employees. All employees must be residents in order to qualify for provincial healthcare.

The reason this is important is that employer-sponsored extended health and dental programs may require provincial healthcare to be in place, as the two programs are complementary.  

For most full-time permanent employees in skilled positions, the expectation is that the employer will provide an employee benefits program with a range of coverage. However, providing an employee benefits plan is not mandatory (please note the province of Quebec has special requirements) and coverage levels differ significantly from employer to employer. Many employers do not provide any extended benefits at all.

While not mandatory, a comprehensive benefits program is integral in attracting and retaining talent, and in protecting and promoting the well-being of employees.

What coverage does a typical Canada employee benefits plan include?

 

Within Canada, when one refers to their employee benefits plan, they are usually referring to the insurance package their employer sponsors, which is typically facilitated through a major insurance provider (Manulife, Sun Life, Canada Life, Blue Cross, RBC Insurance etc).  

We will indicate the most basic components of an employee benefits program, followed by additional benefit offerings that comprise a more comprehensive offering.

The following are the core components of a group benefits plan:

 

Life Insurance

Life insurance amounts are usually either a small flat amount of coverage such as $25,000 or a salary-based benefit such as 1 x earnings, to a maximum. Higher amounts of coverage are usually extended to those in larger companies, or for more highly skilled professional firms employing those in more “white collar” occupations.

Accidental Death & Dismemberment (AD&D) is usually included alongside the Life insurance benefit, for the same amount of coverage.

For small groups, Life Insurance and AD&D are usually a very inexpensive component of the program, often running just a few dollars per employee, per month. The cost varies depending on the demographics of the group, and the overall volume insured.

Extended Health Care

As mentioned previously, Canada has universal health care. Extended Health Care is exactly that – an extension of the basic components provided through the provincial programs. Provincial healthcare is complex and differs across the country. The most simple way to understand what an employee benefits plan provides is to focus on the core components of a typical extended health care package:  

  • Prescription drugs
  • Paramedical practitioners (massage, physiotherapy, chiropractor, naturopath, therapists etc).
  • Vision Care (eye exams, contact lenses, glasses)
  • Medical Equipment (orthotics, knee braces, crutches, wheelchair)
  • Emergency Medical Travel Insurance

The categories listed above fall outside the scope of what is covered through our provincial health care, which provides coverage for doctor visits (including specialists), hospital care, surgeries, diagnostics etc. There are exceptions to all of the above, for example, for low-income households, children, or certain medications such as those dispensed in hospitals.

In short, while we have a robust universal healthcare system in Canada, many day-to-day routine medical expenses are not covered for average working people, and thus, an employer-sponsored group benefits program fills this gap.  

A typical extended health care program will provide coverage for the areas listed above; where a plan becomes more competitive than another is based on the percentage of reimbursement and dollar limits included for various items. It is important to use a qualified advisor who knows the market in order to ensure you are providing a competitive program for your industry, size and location.

Dental Care

For most people, dental coverage comes via their employer program. It is not part of Canada’s universal healthcare system, although programs exist to provide dental coverage to low-income individuals (including the new Canadian Dental Care Plan).

A typical dental plan provides at minimum “basic” coverage which includes cleanings and routine maintenance procedures. The second level of coverage is for “major” dental, followed by a third level, for orthodontics.

It would be common to see a small employer provide only basic coverage, whereas a larger company, or those with highly skilled professionals on the higher end of the income spectrum, tend to provide better dental coverage.

 

In addition to the core components listed above, many programs provide:

  • Long Term Disability insurance
  • Short Term Disability insurance
  • Critical Illness insurance
  • Health & Wellness Spending Accounts
  • Retirement Savings Plans

Long-Term Disability Insurance

Group Long Term Disability insurance provides salary continuance for those who are unable to work due to injury or illness and are therefore deemed “disabled” per the terms of their contract. Typically, Long Term Disability begins after 120-180 days of disability.

During these initial months, a person would be either on Short Term Disability coverage or would claim EI Sickness benefits through Service Canada (the federal government). This is a program that people pay into, as part of payroll taxes.

Many smaller employers do not provide group long-term disability insurance; they may not qualify to obtain this coverage, or they may choose to exclude it due to reasons such as cost.

Short-Term Disability Insurance

While most employers rely on Employment Insurance Sickness Benefits rather than insuring Short Term Disability, insuring this benefit does make sense in certain industries and for specific demographic profiles. Federal EI Sickness Benefits are 55% of weekly earnings to $668 per week (taxable, 2024 amount) so an obvious reason to insure this benefit is for greater coverage amounts that provide for greater income replacement levels. There are other advantages as well, which a qualified advisor can assist you in understanding.

Critical Illness Insurance

Critical Illness insurance provides a lump sum payment based on the diagnosis of one of the covered illnesses (cancer, heart attack, stroke, MS, for example). This is different than Long Term Disability insurance in that it provides a lump sum payment, rather than an ongoing income stream, and you can claim while still actively at work. Comprehensive programs often include this coverage in amounts ranging from ~$10K to $50K per employee.  

Health & Wellness Spending Accounts

An extremely popular offering, Health & Wellness Spending Accounts provides a lump sum dollar amount to be used at the employee’s discretion, for health and/ or wellness expenses.

In Canada, Health Spending Accounts usually refer to non-taxable medical expenses that the Canada Revenue Agency lists as “eligible.” In contrast, Wellness or Lifestyle Spending Accounts cover other items related to fitness and lifestyle and are a taxable benefit to employees. The amounts extended to employees vary significantly between employers, but it is important to remember that a Health Spending Account is intended to supplement insurance, rather than replace it.  

As HSA in the U.S (“Health Savings Account”)  is commonly used, please note that HSA in Canada (Health SPENDING account) should not be used or googled interchangeably. They have some similar aspects but operate totally differently.

Group Retirement Savings Plans

 Many employers provide their employees with Group Retirement Savings plans. In Canada, these typically take the form of a group Registered Retirement Savings Plan (RRSP), often in combination with a Deferred Profit Sharing Plan (DPSP). The purpose of these programs is to assist employees in saving for retirement, in a tax-advantaged way. The Immix Group has written extensively as to the benefits of group retirement savings plans for both employers and employees.

Also, please note that both the employer and employee contribute to the Canada Pension Plan (CPP) or Quebec Pension Plan (QPP). The contribution rates change annually. This is a mandatory payroll tax and would not be considered an ‘employee benefit’ here in Canada, although it does provide income in retirement.

  

Other Important Considerations

 

Maternity and Parental Leave

We are often asked about Canada’s well-known maternity and parental leave policies. In short, Employment Insurance (which provides for Sickness benefits) also provides benefits during maternity and parental leave. The formula used is the same, at 55% of weekly earnings, to a maximum ($668 per week, 2024). The choice of either 12 months or 18 months of leave is indicated upfront; you receive the same amount of total pay (i.e. if you choose the 18-month option, your payment is lower than under the 12-month option).

There is extensive information on the Service Canada website regarding EI Maternity and Parental benefits. There is very little involvement by the Employer in this matter; employees apply directly to Service Canada and are paid directly.  

Additionally, some employers will provide ‘top-up’ pay for those on maternity leave either for a portion or for the entire duration of the leave. This practice varies significantly between employers.

 

Vacation / Paid Time Off

The Employment Standards legislation in each province and territory sets out the minimum legal requirements. In practice, many employers exceed these minimums when it comes to Paid Time Off. Depending on the province, employees may have minimum paid sick days as well; for example, in BC, employees are entitled to 5 paid sick days which is available to both part-time and full-time workers.


Workers’ Compensation Insurance (WCB):

Certain industries require employers to set up workers’ compensation insurance; this is managed at the provincial/ territorial level. Employers fund workers’ compensation through premiums. This program coordinates with other insurance; for example, an injury on the job would result in disability paid via worker’s compensation, rather than through the long-term disability insurance program.

 

Working with a Licensed Employee Benefits Advisor

 Insurance providers require that Employers work with licensed insurance advisors in order to obtain pricing and implement and manage a group benefits program on an ongoing basis. In addition to being a requirement, employee benefits experts such as those at the Immix Group can advise you each step of the way. Advisors provide:

  • Knowledge of Providers: Recommend reputable insurance providers and benefit administrators who operate in Canada. This often is part of the market survey process.
  • Customize Benefits Package: Tailor the benefits package to align with the specific needs and preferences of your Canadian workforce. Consider utilizing templates from the advisory team to conduct surveys or interviews to understand the group’s priorities.
  • Compliance with Collective Agreements: Ensure that your benefits package adheres to the regulations of the province(s) where your employees are based. Be aware of any collective agreements that may apply.
  • Effective Communication: Having benefits is one thing, clearly communicating the benefits package to your Canadian employees is another. Provide written materials and in-person/online meetings explaining the benefits, enrollment procedures, and other relevant information.
  • Smooth Enrollment Process: Implement an efficient enrollment process for Canadian employees. This could involve online portals, paper forms, or a combination of both.
  • Training and Support: Offer training and support to your HR staff responsible for administering the benefits package. Ensure they understand Canadian regulations and can address employee inquiries.
  • Regular Review and Updates: Periodically review the benefits package to keep it competitive and compliant with Canadian laws.

 

What do you need to get started?

When it comes to branching out into Canada, here are some key considerations:

  • Are the employees Canadians or relocating to Canada?
  • Is the company incorporated in Canada?
  • Is Canadian payroll established?
  • Do you have at least 1 or 2 employees already hired?

 

Expanding your business into Canada offers tremendous opportunities, but understanding the local landscape, particularly when it comes to employee benefits, is crucial. With Canada’s unique healthcare system, employment standards, and regional variations, it’s essential to work with experts who can guide you through the complexities. By aligning your offerings with the expectations of Canadian employees, you set a strong foundation for your company’s success in this new market.

If you’re ready to get started, our team at Immix Group is happy to help! Email us at info@immixgroup.ca or call us at (604) 688-5559. We love to hear from you!

FAQs

The first step is to determine whether your company is incorporated in Canada and whether you have established a Canadian payroll. This ensures compliance with Canadian regulations and allows you to provide benefits that meet local standards.

Canada’s universal healthcare system covers basic medical needs, but it does not cover services like prescription drugs, dental care, or vision care. Employer-sponsored benefits typically supplement these areas, providing additional coverage for employees.

A typical benefits plan in Canada includes life insurance, extended health care (covering prescription drugs, paramedical services, and more), dental care, and possibly long-term disability insurance and retirement savings plans.

Yes, there are regional variations in healthcare coverage and employment standards across Canada’s provinces and territories. It’s important to tailor your benefits program to align with the specific regulations and needs of employees in each province where you operate.

While it’s possible to offer a standard benefits plan, it’s often beneficial to customize the plan based on the specific needs of your Canadian workforce, industry, and location. Consulting with a local advisor can help you make these adjustments.

Licensed advisors are essential in helping you navigate the Canadian market. They recommend reputable insurance providers, ensure compliance with local regulations, customize your benefits package, and assist with effective communication and enrollment processes.

Clear communication is key to ensuring employees understand and appreciate their benefits. This can involve providing written materials, holding in-person or online meetings, and offering ongoing support to answer any questions your employees may have.

Read more:

Government of Canada – Employee Benefits Overview

Canada Life – Group Benefits for Employers

Prescription Drug Insurance | Régie de l’assurance maladie du Québec (RAMQ) (gouv.qc.ca)

How Does Workers Compensation Work in Canada? – Canadian Payroll Services

Manulife – Employee Benefits Solutions

Sun Life – Employee Benefits and Group Insurance

Blue Cross – Employee Benefits Plans

Howard 2

Howard Cheung | BBA | Employee Benefits Consultant

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

Posted on by Immix Group

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:

EAPs – how these programs can benefit both employees and organizations

Mental Health Week – CMHA National

72% of Canadian workers prioritizing mental health: survey

79% of Canadians would use mental-health services more if cost wasn’t a factor: survey

May Wellness Spotlight

 Embracing compassion in everyday life 

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

Government of Canada: About Mental Health

Lindsay Byrka

Lindsay Byrka, CFP® BA, BEd

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

Posted on by Immix Group

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.

Table of Contents

  1. Canada Dental Care Plan (CDCP)
  2. National Pharmacare Initiative: Continued Expansion
  3. Prescription Birth Control and Hormone Replacement Therapy
  4. Diabetes Medications & Devices
  5. Service Canada Employment Insurance Extension for Sickness Benefits  
  6. Latest Insights
  7. There’s No One-Size-Fits-All—For Benefits or for People
  8. A Thoughtful Plan Design with Comprehensive Mental Health Supports
  9. Start with Clear, Consistent and Open Communication
  10. Mental Health Claims Make up over a Third of Disability Claims
  11. Early Intervention is Key
  12. The Cost of a Disengaged Leave
  13. Plan Proactively: Support Your People and Your Organization
  14. Return to Work with Support and Compassion
  15. Engagement Matters at Every Stage
  16. More Than Just a Benefits Program
  17. Top 8 FAQ’s
  18. Top 5 key takeaways:
  19. Latest Insights
  20. Health and Wellness Spending Accounts are Increasing in Popularity
  21. What is a Health Spending Account? 
  22. What is a Wellness Spending Account (WSA)?
  23. What is a Flexible Spending Account?
  24. The Benefits: Why More Employers are Implementing Health Spending Accounts
  25. Health Spending Accounts vs. Traditional Insured Benefits
  26. A Predictable, Low-Cost Benefit for Employers
  27. What kind of Employer should implement a Health Spending Account?
  28. How to Set Up a Health and Wellness Spending Account
  29. Top 10 FAQs
  30. Latest Insights
  31. The Workplace Has Changed—Have Your Benefits?
  32. Latest Insights
  33. Expanding into Canada? What Non-Canadian entities need to know when implementing an Employee Benefit program in Canada
  34. FAQs
  35. Virtual Health Care is Everywhere: Employer vs. Free Options, and the latest in Offerings.  
  36. Free vs Paid Options
  37. Free Virtual Healthcare Options
  38. Virtual Mental Health Platforms
  39. Virtual Health is here to Stay!
  40. FAQ’s on Virtual Care
  41. Can a virtual health care provider prescribe medication?
  42. Can I see a specialist through a virtual care provider?
  43. Can I access virtual care if I’m not in one of the provinces where it’s insured under provincial coverage?
  44. Can I see my own doctor through virtual care?
  45. How do I connect with a virtual provider?
  46. Key Takeaways
  47. Extreme Difficulty in Hiring
  48. The Shift to Hybrid Work
  49. The Great Resignation, or rather, the Great Retirement
  50. Continued Focus on Mental Health and Well-being
  51. High Inflation
  52. Federal Dental Plan
  53. Change to EI Sickness Benefits
  54. Flexibility in Benefits
  55. What is MSP?
  56. Who pays for MSP?
  57. Premium Assistance- You might be eligible for a discount!
  58. Do I need to have MSP?
  59. The future of MSP…?
  60. Further reading 

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.

Further Reading:

Canadian Online Doctor Appointments | Tia Health | Book in Minutes

Virtual Care | TELUS Health Care Centres

Lifeworks/Telus  report Mental Health Index

Healthcare Online – On-Demand Healthcare Access | Manulife

Trends & Free Resources in Digital, Virtual & Telehealth Care for British Columbia – Latest News from Immix Group

Tia Health: https://tiahealth.com/

InkBlot Effective Mental Health Care for Everyone | Inkblot Therapy

Lindsay Byrka

Lindsay Byrka, CFP® BA, BEd

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

Posted on by Immix Group

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.

top benefits2

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. 

top benefits3

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:

https://www.statcan.gc.ca/en/subjects-start/labour_/labour-shortage-trends-canada

 

Retirement:

https://www.theglobeandmail.com/business/commentary/article-the-great-resignation-has-arrived-in-canada/

https://thehub.ca/2022-09-20/trevor-tombe-canadas-not-so-great-resignation-its-retirements-we-should-really-be-worried-about/

https://www.benefitscanada.com/benefits/health-wellness/how-can-employers-turn-the-great-resignation-tide/

 

Hybrid Work:

https://www.benefitscanada.com/news/bencan/survey-finds-78-of-canadian-employees-prefer-working-from-home/

https://www.benefitscanada.com/news/bencan/61-of-canadian-employers-using-hybrid-work-model-survey/

https://immixgroup.ca/blog/index.php/2022/03/23/the-hybrid-work-model-is-working-from-home-an-employee-benefit-2022/

https://immixgroup.ca/blog/index.php/2022/04/19/part-2-the-hybrid-work-model-is-working-from-home-an-employee-benefit/

 

Inflation:

https://www150.statcan.gc.ca/n1/en/catalogue/62F0014M2022014

https://www.sunlife.ca/workplace/en/group-benefits/focus-updates/over-50-employees/provincial-dental-fee-increases-for-2022/

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

https://www.benefitscanada.com/benefits/health-wellness/hybrid-work-four-day-workweek-shaping-employee-well-being-expert/

https://www.benefitscanada.com/benefits/health-wellness/2022-healthy-outcomes-conference-centering-employee-well-being-in-return-to-office-plans/

 

Flexibility in Benefits:

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

Lindsay Byrka

Lindsay Byrka, CFP® BA, BEd

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

Posted on by Immix Group

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

Howard Cheung | BBA | Employee Benefits Consultant

Keep Fit From Home

Posted on by Immix Group

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, CFP® BA, BEd

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

BC’s Medical Services Plan: What is MSP – and what does it have to do with your benefits plan?

Posted on by Immix Group

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

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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 

http://www2.gov.bc.ca/gov/content/health/health-drug-coverage/msp/bc-residents/premiums 
http://www.bcchamber.org/policies/small-business-benefits-simplifying-msp-tax-system 
http://www.timescolonist.com/opinion/op-ed/comment-it-s-time-to-rethink-medical-services-plan-tax-1.1744144 
http://www.cbc.ca/news/canada/british-columbia/b-c-premier-says-big-changes-coming-to-msp-premiums-1.3765327