Cost of employer medical benefits forecast to rise 7.5 per cent in 2023

We’ve seen client rate increases be higher in 2023 than we’ve seen in decades and  higher than I’ve seen in the 17 years I’ve been tracking and sharing on my website

With drugs trending up about 6.3%, dental fee guides (in Ontario) up 8.5%, the aging effect on pooled benefits (life and LTD) at 8% or more, it’s really no wonder.  Add in the fact that many people are still playing catch up on getting work done (dental, vision and parameds), that was delayed due to the pandemic, and it was almost expected.  The article below (from January) identified this before the year even started.

Most clients are glad to see staff making use of the plans.  Many are increasing their core benefit offerings, some are adding Health Spending Accounts (HSA’s) and others are increasing existing HSA’s to keep up with inflation.  If times are tight and you’re looking to trim costs, or are interested in looking at cost effective ways to enhance plans, please reach out.

The cost of employer medical benefits in Canada are forecast to rise 7.5 per cent in 2023, according to the 2023 Global Medical Trend Rates report from Aon plc.

“As employer-sponsored medical plans become an ever-increasing part of an organization’s employee compensation, pressure is growing to accurately forecast and manage future costs,” the firm states in its announcement about the report’s publication. “Employers need to understand the factors driving costs to better navigate volatility and make more informed decisions.” They add that the rates discussed are not meant to represent healthcare costs as a whole.

The global average medical trend rate for 2023 is expected to be 9.2 per cent, the highest trend rate recorded since 2015. In 2022 the global average sat at 7.4 per cent in 2022.

In Canada, the annual medical trend rate was seven per cent in 2022, rising to 7.5 per cent in 2023.

Business owners brace for second stage of CPP expansion

I was not aware that the CPP premiums employers pay have risen so much (this and next year), This is a result of the federal governments 2016 announcement to enhance CPP benefits. The change is intended assist those unprepared for retirement and without access to a workplace pension.

In 2023, employers are paying 44.7% more at the top end than in 2018

Business-owner clients struggling to absorb the cost of rising Canada Pension Plan (CPP) payroll contributions over the past five years will get little relief when the second stage of CPP expansion begins in 2024.


Establishing a Working From Home Policy

During the pandemic (and since), we’ve had many of our clients move to remote working arrangements.  On a one to one basis we’ve discussed many of the problems of employees working out of the province/country.  From losing provincial health coverage, to benefit eligibility failing, to tax and residency issues, employers really need to do their homework before allowing employees to work out of Canada.

For employees working remotely within the province, there are still many considerations that could be covered through a well worded policy.  The article below has a good checklist of sorts that you may find useful.

Aird & Berlis LLP’s Workplace Law Group recently presented a webinar entitled Work From Home: The New Normal? which focused on the continuation of work-from-home (“WFH“) arrangements beyond the COVID-19 pandemic, remote work policies and key considerations for employers when administering such arrangements.

 In this bulletin, we address some of the major themes set out in the questions.

The following list sets out the essential elements of a WFH policy:


No need to make plan changes due to EI changes (for most clients)

We have published blog posts on the change in Employment Insurance (EI) extension from 4 to 6 months that took effect at the end of 2022, as well as an article in our newsletter, but wanted to close the loop as there has been questions from clients.

Our advice is to keep all plans STATUS QUO and make no changes.  Here’s why…

  • Clients that have no Short Term Disability (STD or WI) or Long Term Disability (LTD) need not do a thing.  The EI sick benefit provided by the federal government has now been extended to 6 months and their staff will benefit from that.  STATUS QUO
  • Clients that have an LTD plan with a 120 day waiting period, should keep it as-is, even with the EI sick benefit extending to 180 days.  Here’s why…
    • Delaying employees benefit payment in the case of disability, creates a financial hardship for those claiming due to 2 more months at a reduced, taxable EI benefit, until LTD so stay STATUS QUO
    • Employers that have SUBP plans (that top up EI sick benefits) would incur much higher costs for their top up (as 50% longer) so stay STATUS QUO
    • Employees are better served by early intervention by insurers.  This can help with earlier return to work accommodations and less malingering, so stay STATUS QUO
    • Some insurers are actually increasing LTD rates due to a lack of early intervention.  Rates are high enough so stay STATUS QUO

The one caveat to all of this staying STATUS QUO is that the employee needs to stop the EI benefit at 120 days in order to get the higher LTD benefit (without double dipping).  Only they can do so, and most insurers have told us they will remind the employee (to stop the EI claim) when the LTD claim is approved.  Even if the disabled employee forgot and collected both EI and LTD benefits for the 2 months (overlapping), they would only have to pay back the EI benefit (which is less than the LTD benefit payable, so no financial issue).

If you or an employee has any questions, please do not hesitate to reach out.

Pay Transparency Legislation in Canada

Pay transparency legislation is not in Ontario (YET), but it is working its way into law in Prince Edward Island, Nova Scotia, British Columbia, Newfoundland & Labrador. 

Generally this legislation prohibits an employer from asking about a prospective hires wage history.  The article provides more below, but be aware as this may affect you if hiring remote workers in other provinces…

Pay transparency became the topic of much discussion when the province of Ontario tabled legislation in 2018. While this legislation never came into effect (still to this day) other provinces have enacted pay transparency laws and others are considering doing so.


Service Ontario: You Will No Longer Receive Paper Renewal Notice For Driver’s License, Health Card

Important notice to Ontario Residents that you may wish to share with your employees

Ontario announced (in the fall of 2021) that they will be eliminating paper renewal notices for driver’s licences and health cards and shifting to digital reminders like emails and phone calls.  I only noticed this as I renewed my drivers license and was prompted to set up e-mail or text reminders.

Why is this important? and what’s the relevance to our benefit plan?

Employees need to have provincial health coverage in order to be eligible for most benefit plans.  During the renewal process they will be asked about residency (this is why we warn employers about the risks to employees working out of province, especially abroad) and Service Ontario may reach out to confirm it (see clip below).

The web page to renew your Ontario Drivers license and OHIP card is below.

An article showing the chan

HATN – The Great Gourmet Give – Saturday April 15, 2023

I volunteer with a small, local, and 100% volunteer run charity that does some amazing work in Africa.  It’s a great hands on organization that works with the local villages to help them, help themselves. We were over in the fall of 2022, helping build an irrigation system for their Women’s Market Garden.
We are doing a big fundraising event again this year (1st after the pandemic) and are reaching out to friends, clients, and associates to; buy a ticket, donate a silent auction gift, make a donation, come out, have a great night, and learn more about the charity.
If you buy tickets (and let me know), we’ll arrange to put together a few tables, so there are familiar faces (or at least one or two).  Buy tickets at

Saturday, April 15, 2023 – 6:30pm        

The theme for Hands Across the Nations 17th annual Great Gourmet Give is “Experience the Magic of Giving”.

Radio Personality, John Moore of “Moore in the Morning” will host and over 250 attendees will enjoy an evening of wine, gourmet tapas, live entertainment, dancing and silent auction at The Brighton Convention Center, (Toronto). Proceeds from the Great Gourmet Give will transform communities of women and children living in extreme poverty. Tickets are available at at a cost of $175. 

As a 100% volunteer-run organization, HATN relies on the support of generous individuals and businesses to further our commitment of changing lives community by community. HATN embraces global community partnerships with a focus on clean drinking water, healthcare and education.

HATN’s ambitious goal to raise $50,000 will be used in Jammeh Kebbeh, the Gambia to:

  • Build a Bush Hospital to provide life-saving healthcare and maternity care for 9,000+ villagers who currently have little to no access.
  • Install a water tower with a closed drilled well for the hospital. Finding and collecting water consumes a large portion of time and worry for women and children. Village wells are either broken and unsafe and water when available is undrinkable by most standards. The well at the hospital will be shared with the community.

Our projects…

4 Schools & 4 Health Clinics Built | 200 Water Filters Installed | 22 Sanitation Facilities & Greenhouses Built

HATN projects are a testament to our dedicated volunteers, donors and sponsors. Today, classrooms overflow with eager students ready to learn. Women attend night school. Medical aid is accessible, affordable and saving lives; increasing life expectancy, opportunity and hope. 80% of the water filters continue providing clean drinking water for over 10,000 lives.

Thank you in advance for your contribution consideration. We will provide donor recognition on website, social platforms, event program and public announcements.

With Gratitude,

The Great Gourmet Give Team

Is Your Employee Exempt From Employment Standards Legislation?

As a Mainstay Insurance client you know that we do NOT allow independent contractors to be included on benefit plans.  There are a number of reasons for this.  CRA does not allow non-employees, most insurers will not change contract wording to include non-permanent employees, and most importantly, there is considerable liability created for both the the employer and employee if they are deemed as such.  We never want the benefit plan to be the “final nail in the coffin” that redefines an independent contractor as an employee.

In Ontario (as of Jan.1, 2023), things are getting a bit messier, but maybe also a bit clearer at the same time.  If you work with business or information technology consultants, then please read the info below and reach out to your HR or employment lawyers if you have questions.

On January 1, 2023, an amendment to the Ontario Employment Standards Act, 2000 (“ESA”) came into force that creates a new exemption for business and information technology (IT) consultants.1 This means that if an individual meets the criteria for a “business consultant” or “information technology consultant” under the ESA, then the consultant is excluded from the application of the ESA. If that is the case, then the employer does not have to comply with the minimum employment standards set out in the ESA with respect to the consultant.

Employers should consider whether this new exemption applies to any individuals in their Ontario workforce. In addition, it is also a good reminder for employers to consider whether they are up to date on key exemptions from employment standards legislation in all of the provinces and territories in which their business operates, as the exemptions do vary by province and territory.


2023 HR Checklist For Ontario Employers

Here are some of the recent changes, and others coming in the near future.  Though not directly benefit related, it is a good checklist to reference and ensure you are on-side with.  Any questions, reach out to your employment lawyer or applicable professional.

Effective January 1, 2023, private companies incorporated in Ontario must establish and maintain a Register of individuals with significant control (“ISCs”)

Effective December 18, 2022, Employment Insurance (“EI”) sickness benefits were extended permanently from 15 weeks to 26 weeks.

Effective June 1, 2023, Ontario’s Occupational Health and Safety Act (“OHSA”) has been amended to require that certain employers provide and maintain a naloxone kit in workplaces

Ontario employers can no longer enter into non-competition agreements


Dental Fee Guide Increases & Prescription Drug Trends

Near the end of December, I shared the Ontario Dental Fee guide increases and at that time, we were still waiting to hear on the other provinces and their adjustments for 2023.  They are now out and the averages are included below.

In addition to the fee guide increase, employers also have trend and utilization drivers to cost (using more of the services, and using them more often, in addition to paying more for the same service). We are seeing these costs show up (already) with the first months dental claims being higher than normal, and do not anticipate that abating.

On the drug side of things, costs are continuing to stay stable, but having an employee with one of the nearly 200 high cost drugs (over $10,000 a year), can have a huge affect on renewal pricing (but we have solutions).  A post in Pension and Benefits Monitor Magazine today stated…

Prescription drug expenditures by Canadian public drug plans increased by 4.2 per cent in 2020/21, bringing annual spending to $12.3 billion, says a Patented Medicine Prices Review Board (PMPRB) report. The use of higher-cost medicines has been the primary factor behind rising costs for public plans over the past five years and this pressure continues to build, it says, as in 2020/21 high-cost drugs accounted for over one third of total drug costs and yet were only used by 2.5 per cent of drug plan beneficiaries. The 10 highest-cost drugs reimbursed by the public drug plans were all rare disease treatments with annual treatment costs of over $200,000.

Put together the dental and drug inflation, trends and utilization increases and we expect to see larger than average renewal rates in the next few years.

As always, we share our numbers HERE.

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