When the Molson Coors Beverage Co. introduced gender affirmation benefits for its Canadian workforce early this year, it was an extension of its diversity, equity and inclusion goal to make the traditionally male-dominated brewing industry a more welcoming place for underrepresented groups.
The gender affirmation benefit, which was first offered to the brewing company’s U.S. employees, reimburses staff for procedures not covered by provincial and territorial governments, such as facial feminization procedures, tracheal shaving, laser hair removal, vocal therapy, pectoral implants, cheek fillers and more. Canadian employees also have access to fertility drug coverage up to a lifetime maximum of $15,000.
“We want, as an employer, for people to embrace their whole selves and we want to accompany them through this process because we know it’s very life-defining,” says Michael Nordman, Molson Coors’ senior community affairs manager. “And we want to make sure they have access to all the benefits they need.”
Gender affirmation benefits can also help recruit and retain talent from the LGBTQ2S+ community, as well as allies who value the company’s commitment to trans staff, he adds. “We want our employees to reflect consumers as a whole. That only helps our brand and our company speak better for those consumers.”
Helping employees affirm their gender
Molson Coors is just one of many employers seeking to incorporate their DEI strategies into their benefits plans.
Plan sponsors are increasingly interested in adding benefits that serve diverse needs or expanding their core coverage to include options that speakto a broader range of life experiences.
“It’s top of mind for all organizations right now,” says Marie-Chantal Côté, senior vice-president of group benefits at Sun Life. “We have the luxury of living in a country with a diverse landscape and that comes with diverse needs. Organizations are putting their focus on talent
attraction, retention, engagement and the health of their employees.”
A new survey by Sun Life and Ipsos found an inclusive benefits plan is very important to one in four plan members and to 50 per cent of plan members who identify as part of an equity-seeking group, including Black Canadians, Indigenous people, LGBTQ2S+ employees and those who have a disability.
While linking DEI and benefits is growing in popularity, it’s still considered the “next frontier,” according to a 2021 Aon survey, which found employers that do so are still in the minority. Indeed, while the majority of Canadian human resources professionals surveyed acknowledged the importance of organization-wide DEI initiatives, 62 per cent said they felt their benefits offering was sufficient for all of their employees.
The results indicate many organizations’ programs are still built on a one-size-fits-all mentality, according to Aon. “The centre of DEI is the individual,” says Joey Raheb, the consultancy’s senior vice-president of health solutions.
“For so long in group benefits, we focused on the group — everybody gets the same thing . . . and for us, that meant fair and equal. But it isn’t [equal] when only 10 per cent of the population uses [X] benefit and only five per cent uses [Y] benefit and 90 per cent sees no value. We’ve [gone] at it from an in-the-box approach . . . and I think that’s the wrong way to look at this.”
Mila Lucio, executive vice-president of HR and social impact at Green Shield Canada, says the insurer is seeing interest in gender affirmation benefits and coverage in the requests for proposals it receives from employers.
Indeed, gender affirmation benefits have grown quickly in popularity in the past few years.Sun Life added coverage for basic surgical procedures not covered by the provinces and territories
to its extended health-care plan in 2019, Medavie Blue Cross introduced it in late 2021 and, also last year, Green Shield Canada made the coverage part of its standard benefits with an overall lifetime maximum of $10,000.
Accenture was one of the first employers in Canada to support transgender employees through its benefits when it started offering gender affirmation coverage in 2011. Susan Goodyer, the organization’s head of HR in Canada, says the offering was part of the company’s goal to be the “most inclusive and diverse company globally,” noting Accenture had to work with the insurance community and the World Professional Association for Transgender Health to develop the benefit at the time. It covers all costs not covered by public health care, including surgical procedures, hormone therapy, hospital stays and associated paramedical services.
In the years since introducing the benefit, the company simplified the process by reducing the level of professional documentation required and its previous requirement that the user be at least 18 years old, says Goodyer. “We do need to make sure that our benefits are inclusive and accommodating to a broad range of employees.”
Addressing family building
Larger employers have also started looking to benefits that help employees plan their families, including coverage for expensive fertility treatments and drugs, as well as adoption and surrogacy costs.
“So many people are struggling with that,” says Lucio. “It’s a huge aspect of life and accessibility and affordability can vary by group.”
In February, TD Banking Group enhanced its family planning supports for all employees to boost the lifetime maximum for fertility drugs and procedures, including in vitro fertilization, and introduced coverage for surrogacy, donor and adoption costs including legal services, embryo storage, midwife and doula classes, fees for licensed adoption agencies and child immigration costs. Each benefit has a lifetime maximum of $20,000.
“Growing families looks different for everyone,” says Susy Michor, vice-president of HR, global retirement, benefits and well-being at TD, noting the changes were in response to hearing from employees about their needs.
Cisco Canada, Pinterest, Scotiabank and Snap Inc. are some other employers that offer coverage for family planning. Social media company Snap covers up to $65,000 for fertility and adoption expenses and up to $130,000 for surrogacy expenses. On the insurance side, Green Shield Canada recently added fertility benefits to its group plans with an annual maximum of $5,000 to cover IVF and artificial insemination procedures.
However, these leading employers still represent the minority. According to a February 2021 study by fertility patient groups Conceivable Dreams and Fertility Matters Canada, just five per cent of Canadian employers provided coverage for both fertility drugs and other fertility costs. The median lifetime maximum was $3,250.
The average cost of one round of IVF is approximately $20,000 — though patients in Ontario can have one round covered by provincial health care — and surrogacy can cost upwards of $80,000, according to the patient groups. In October, Fertility Benefits Canada called for more employers to cover these expenses as a way to compete in a tight labour market.
Broadening core benefits
While some benefits may be too cost-prohibitive for smaller employers, Kim Siddall, Western division vice-president of enterprise consulting for People Corporation, says wellness accounts can help them introduce more options for employees.
“The easiest thing is to introduce elements of choice. A wellness account goes a long way to supporting diverse needs in benefits coverage without having to amend the contract.”
These accounts allow employers to cover everything from expenses related to childcare or elder care to health and wellness costs for employees living with chronic conditions and culturally relevant benefits such as traditional medicines that wouldn’t be approved under a drug plan, says Raheb.
In 2019, TD updated its wellness account coverage to include natural health remedies and traditional Chinese herbal, Indian and Indigenous medicines as eligible expenses. “We’re always looking at our benefits offering and assessing how we can support the diverse needs of our colleagues and respond to what they’re sharing with us,” says Michor.
Côté says it’s important to remember the core benefits offerings often “have more breadth in them than people imagine,” pointing to health-care spending accounts and paramedical coverage for mental-health providers as two areas that can be expanded to meet the needs of specific employee groups.
Diversity in the drug plan
Joanne Jung, pharmacy practice leader at WTW, says employers reconsidering their benefits plan design through a DEI lens may want to take a closer look at their drug formularies, as many plan sponsors are unaware of what’s covered or excluded by default in their plan, particularly when it comes to supplemental drugs.
The bucket of supplemental drugs tends to include what’s been traditionally viewed as lifestyle medications, such as those for erectile dysfunction, fertility, obesity and smoking cessation. Given the changing understanding of obesity as a chronic condition, employers may want to re-evaluate covering those drugs in their plan, she says. Fertility drugs, meanwhile, may have low lifetime maximums.
Plan sponsors introducing gender affirmation coverage may also want to make sure their drug plans allow claims for drugs for cosmetic use, says Jung, which have typically been excluded from coverage.
Developing more inclusive language
Outside of benefits offerings, employers and insurers are also looking to update the language and imagery in their communications materials.
Simple changes, such as changing references to he/she pronouns on forms to the more gender-neutral they/them, can have a significant impact, says Raheb. Plan sponsors can also consider the literacy level of their policy documentation or communications to ensure they’re at a level that everyone understands and evaluate whether to add a third language if their organization has a concentration of employees who speak a language other than English and French.
According to Sun Life’s survey, 40 per cent of plan members who were in diverse groups said their employer’s benefits communications could better align with their needs, be more inclusive or have more imagery of diverse groups.
TD is continuously assessing the ways it communicates benefits to staff, says Michor. In 2019, the bank introduced new videos, tools and resources, which included diverse employee profiles. And in 2020, it refreshed its benefits booklet to introduce they/them pronouns in place of he/she.
Green Shield Canada expects to soon finalize a project aimed at removing biases on all forms and the online administration process, says Lucio. This includes changing gender labels to sex labels and adding options such as nonbinary, unidentified and undisclosed.
“We don’t all appreciate what the impact is for folks that identify as part of those groups [and] how difficult, stressful and traumatic it can be to fill in a document that requires them to identify as part of a group they don’t identify with.”
A permanent change
Côté expects the trend toward diverse and inclusive plans to continue as employers seek to attract key talent and help staff become healthier and happier — journeys that can look different for employees from different demographics.
As well, she says, employers are facing higher expectations from stakeholders to achieve high standards in sustainability and DEI. Michor agrees, noting employees expect more from their employers around their benefits and a “culture of care” than they did pre-pandemic.
“We’re going to continue to listen and evolve our benefits, make sure we’re responding to people’s unique needs and maintaining a competitive edge. Leading organizations will need to be known not only for cultivating inclusive workplaces, but also for advocating for an inclusive society.”
Kelsey Rolfe is a Toronto-based freelance writer.