More than half of Canadians are putting off essential health services due to cost, a stark indicator that the country’s health insurance system is struggling to meet growing needs.
According to PolicyMe’s 2025 Insurance Access and Affordability Study, 56% of Canadians are delaying care.
As employers grapple with budget pressures and Canadians question the adequacy of their coverage, experts agree that insurance brokers need to step beyond transactional roles and more actively assume a role as advisors.
Andrew Ostro (pictured right), CEO of PolicyMe, says that while most employers are doing their best to maintain benefits, constrained budgets mean the coverage is often too shallow to meet employees’ real needs.
“That has a lot to do with the costs of this care, and employers unfortunately just don't have the budgets to spend a lot more. As costs have gone up, there's only so much you can get for your dollar,” he said.
“One in five Canadians below the median income feel that their health benefits don’t meet their needs,” she noted, adding that the crisis deepens when factoring in demographics.
Women are twice as likely as men to report anxiety about affording care. The same is true for part-time workers and those living with a chronic condition or disability, who also face double the likelihood of financial stress related to their health.
“That’s an affordability crisis, right there,” she said.
While employees face rising out-of-pocket expenses, employers are also under mounting pressure. Ostro points out that even well-intentioned companies are finding it difficult to maintain meaningful coverage levels amid escalating healthcare costs.
“The answer isn’t going to be: ‘Hey, employer, go double your spend on benefits’,” he said.
Ostro noted that 36% of Canadians are concerned their employer-provided coverage could be reduced or eliminated amid rising economic instability. With global trade tensions, the looming risk of a recession, and widespread financial anxiety, many companies are being forced to make difficult cost-cutting decisions - including within their benefits programs.
Schmidt echoes the sentiment, emphasizing that employers are juggling multiple external stressors that make long-term planning difficult.
“They are overwhelmed, too,” she said, adding that employers are facing geopolitical instability, economic uncertainty, and climate disruptions like recent forest fires in Canada.
Schmidt and Ostro agree that brokers are uniquely positioned to bridge the gap.
Ostro believes brokers need to take a more active advisory role – one that goes beyond simply selling “pre-packaged plans”.
Rather than defaulting to cookie-cutter packages, brokers can help employers reconfigure their plans to prioritize essential care over more discretionary perks, he said.
That might mean dialing back benefits like massage therapy in favour of more robust dental or mental health coverage, especially as costs climb and dollars stretch less than before.
“Maybe there are more frivolous things that you can cut from the plans that aren't necessarily essential,” he said.
There’s also an opportunity to reframe how individual plans are viewed. Traditionally seen as a fallback for people without workplace benefits, Ostro believes they can also serve as critical supplements to thin group plans – filling in the gaps left by employer coverage.
Brokers can help employees identify those blind spots and suggest affordable top-up options to ensure they’re not going without crucial services.
This kind of advisory approach, Ostro added, is becoming more essential in a market that’s only getting more complex.
Schmidt agrees. While it can be more challenging for smaller companies, she says personalization and smarter spending are both possible – and necessary.
Schmidt says that tools like digital health components and bulk-buying opportunities can make personalization more attainable and cost-effective.
The payoff, she says, isn’t just financial. Mercer’s data shows that 74% of employees who receive personalized benefits believe their employer cares about their well-being. Among employees who lack that customization, she says that number drops to just 30%.
Brokers who can help clients communicate benefits clearly and align them with real employee needs are playing a crucial role, she added.
“In today’s market, being seen as a caring employer is actually a competitive advantage,” she said.
