Balancing benefits plan sustainability against meeting the evolving needs of employees continues to keep Canadian plan sponsors up at night.
“I think since COVID we’ve seen such a shift in expectations [around] work-life balance, a focus on [diversity, equity and inclusion] and mental health,” said Laura Carter (pictured left), associate director of benefits at the Healthcare of Ontario Pension Plan, during a panel discussion at Benefits Canada’s 2025 Toronto Benefits Summit.
“We need to make sure we are addressing those needs, but also the intent of the benefits plan is to support the collective needs of the group, not necessarily the unique needs of each individual.”
Read: How 5 employers are designing mental-health benefits that cater to a diverse workforce
The HOOPP now conducts annual data reviews, assessing aggregate reports on drug, benefits and employee assistance program utilization data, as well as benchmarking reports and exit interview data. It also hosts focus groups with employee resource groups. The goal is to investigate any “recurring themes” and whether there’s a business case to revisit or add a benefit.
“We found the exercise in itself gives us confidence that we’re on track and upholding our fiduciary responsibility and we’re not just checking a box,” said Carter.
Also speaking on the panel, Tracey Riccardi (pictured right), vice-president of compensation, benefits and human resources systems at Gateway Casinos and Entertainment Ltd., said those competing pressures are on her mind as well. “The needs of our employees are changing, so the benefits plan needs to change. So how do we [keep] the plan sustainable for the needs of our employees?”
This balancing act is playing out against the backdrop of an increasingly strained public health-care system. For the first time, the 2025 Benefits Canada Healthcare Survey — which surveyed 1,000 Canadian plan members and 500 plan sponsors — asked employees if they felt overdue to see a doctor for any reason, such as a check-up or a diagnostic test.
Forty-four per cent said they did feel overdue, higher among respondents without a family doctor, newcomers to Canada and 18- to 34-year-olds. Interestingly, of the 78 per cent of plan members with a family doctor, 37 per cent still felt overdue for a visit. Half of people who had no chronic condition or major injury and those in excellent or very good health also felt in need of a doctor’s visit.
Read: A deep dive into health-care navigation guides
“We’re definitely seeing that — across the country, employees are coming forward asking for support because they don’t have a [general practitioner] and can’t find one,” said Riccardi. “We’re looking at virtual-care options to bridge the gap, but a GP is a pivot point. It helps to tell the medical story of an individual.”
Riccardi also called on provincial governments to step up and work harder to attract and retain health-care workers.
The HOOPP added virtual care this year based on feedback from employees, said Carter, noting plan sponsors can also help to promote preventative health and wellness practices that can relieve strain on the public system.
In this vein, the organization has hosted biometric screening clinics that enabled employees to book 15-minute appointments and get baseline health information they might not have without a doctor’s appointment.
Download the full 2025 Benefits Canada Healthcare Survey report here.