Gender gaps in group benefits leave women underserved, says RBC Insurance

Despite women making up half of Canada's workforce, their employer-sponsored benefits are failing to keep pace with their health needs, according to RBC Insurance. 

It notably raises hard questions about whether group benefits programs are built for the workforce that exists today rather than one stuck in the past.

“Women's needs are misaligned when it comes to the employer group benefits programs,” said Tony Bruin, head of group benefits at RBC Insurance. “Seventy-five per cent of women that we surveyed said that they wanted or needed benefits that specifically supported women's health and that could be a variety of different things, whether it's fertility, perimenopause or menopause supports, or other health and well-being supports.”

There's also a cost dimension that notably compounds the problem, Bruin noted, as two thirds of women cited rising costs as a barrier to their well-being, compared to 51 per cent of men.

Paula Allen, global leader of research and insights at TELUS Health, agrees the industry has been slow to act. She acknowledged that plan sponsors have not historically treated women's health as a distinct need, and while momentum is building, most programs zero in on menopause without considering the full lifecycle, adding that "whilst women's health remains largely uncovered, the unaddressed health needs specific to men are being uncovered as well," she said in a statement.

Bruin points to the survey data, which broke overall well-being into mental, physical and financial pillars. Across all three, men rated themselves in better shape than women where men were more likely to describe their mental and physical health positively, and the gap was widest on financial health, where under four in ten women felt secure.  According to Bruin, 39 per cent of women in the survey reported struggling with disabilities associated with mental health, versus 24 per cent of men.

"That could be just a difference between men not being as willing to talk about it or reveal that, so that could reveal a problem in and of itself," he said.

When plan sponsors design benefits with insurers and advisors, they need to understand where their own workforce is struggling and adjust accordingly, Bruin emphasized. In workplaces with a larger proportion of women, that could mean placing greater emphasis on menopause and fertility supports, alongside stronger mental health resources. Education is part of that work as well, because he believes a blanket approach is no longer acceptable.

“There isn't a one-size-fits-all anymore associated with group benefits," he said. "We have to make sure that we're understanding our populations and really tailoring to them. Plan sponsors can start optimizing their group benefits by looking closely at their specific workforce characteristics and tailoring plans to ensure equitable and inclusive coverage,” added Bruin, pointing to health spending accounts as a flexible tool that lets sponsors maintain budget discipline while expanding choice.

Allen acknowledged mental health and cardiovascular health are now covered reasonably well across most plans, but preventative attention for women is only now gaining traction. She points to emerging research connecting menopause with joint pain, differences in medication response based on body size, and a tendency for women to minimize pain and early symptoms. Every program and service, she argues, needs to leverage those insights to improve care for each individual.

On core health coverage, Bruin stressed that benefits can and should be tailored for men and women. That includes contraception, fertility benefits, and hormone replacement therapies, which he underscored are increasingly needed by both genders, whether for age-related testosterone support in men or gender affirmation care. Across the board, he sees mental health coverage as essential for everyone, with a need to break down the lingering stigma that still stops many - particularly men - from speaking up.

According to Bruin, gender-affirming benefits are also appearing more often in plans, typically as optional add-ons that sponsors can choose. While he acknowledges that the reported non-binary population in Canada is still small – roughly around two per cent, he believes the true figure is higher, particularly among younger workers.

He believes this is pushing programs to become more inclusive, acknowledging RBC Insurance has already gone through its contracts and booklets to make the language gender neutral, and has built gender-affirming care into its menu of flexible options for plan sponsors.

Alongside that, he emphasized the importance of employee assistance and other well-being supports to help people navigate the process, from mental health support to guidance on accessing available funding.

To that end, flexibility is the baseline, Allen underscored, noting her team analyzes and assesses workforce needs and provides evidence-based programming, constantly refining the offering based on what the data reveals. Clear and consistent communication is critical to closing utilization gaps, she adds, along with practical access.

"Virtual care, for example, is particularly important for those in caregiver roles, which disproportionately impacts women," she said.

Bruin also highlights the role of insurers in expanding access through virtual care, giving members easier connections to practitioners and services such as dietitians via employee assistance programs. But in his view, one of the biggest missed opportunities is simply awareness. That lack of awareness and communication gap is a sore point for Bruin who notes that one in five working Canadians between the ages of 18 and 35 are unsure of the benefits coverage that they have.

He suggests plan sponsors could get more value from their existing programs simply by telling employees what's available, noting that packaging benefits in a way that feels personal and relevant makes a real difference.

“There's a huge opportunity to for us to educate the whole population in regards to the benefits that they already have access to,” said Bruin.