Jamil Jamal & Taylor Valée make the case for rethinking gender in employee benefits
Most organizations adjust their employee benefits regularly to manage cost pressures, maintain competitiveness against peer benchmarks, or introduce incremental flexibility, yet these changes often occur without a deeper examination of the underlying health realities within their own workforce.
Beneath routine renewals and market-driven enhancements, insurance carrier data continues to reveal meaningful and persistent gender differences in utilization, disability incidence, and chronic disease patterns. When these differences are left unexamined, the risk is not merely theoretical. It manifests in longer disability durations, higher pharmaceutical spends, preventable absenteeism and disability, stalled mid-career retention, and avoidable turnover of experienced talent.
In an ever-evolving industry that continues to be male-dominated, it is incumbent upon all benefits consultants to learn, gain insight, comprehend data, and implement best practices for Canadian employers. In an environment where workforce resilience and cost control are strategic priorities, inaction carries measurable financial and operational consequences.
As an example, women in Canada are more likely than men to meet the criteria for mood and anxiety disorders, particularly at younger ages. Consistent with this, women are also more likely to access treatment. IQVIA’s Canadian dispensing data shows that in 2023 approximately 22.1 percent of women were dispensed antidepressants, compared with 11.1 percent of men, a gap that has remained consistent over a five-year period across provinces.
Clinical evidence further notes that depression prevalence in women is influenced by hormonal transitions during pregnancy, postpartum periods, perimenopause, and menopause. These life-stage shifts frequently coincide with peak career and caregiving demands, intensifying both psychological and physiological strain.
Beyond mental health, these transitions illuminate a broader structural issue. Women’s health risk is frequently addressed reactively rather than preventively. Pelvic floor dysfunction, for instance, is commonly treated after childbirth, despite growing clinical recognition that proactive pelvic floor assessment and strengthening prior to delivery can reduce long-term complications.
Similarly, perimenopause can begin years before menopause itself, yet workplace health strategies rarely account for its documented effects on sleep, cognition, mood, and musculoskeletal function. When benefit design focuses exclusively on acute intervention, it overlooks opportunities to mitigate predictable downstream risk.
Prescribing practices also merit careful examination. Some reports suggest that women presenting in primary care with fatigue, sleep disturbance, or stress may be more likely to receive antidepressant prescriptions.
In certain cases, underlying contributors such as thyroid dysfunction, iron deficiency, chronic sleep disruption, trauma exposure, or perimenopausal transition may not be fully explored. Elevated prescribing rates do not necessarily signal overdiagnosis, but they do raise important questions about whether plan design inadvertently favours pharmacological intervention over multidisciplinary care, particularly when psychotherapy access is financially constrained.
The more consequential question is how plan sponsors respond.
A starting point involves disciplined analysis of data. Plan sponsors should work with their consulting partner to scrutinize claims and identify disability trends by gender and age bands, examining prescription drug trends, psychotherapy utilization, and musculoskeletal claims. Retention and absence patterns among mid-career employees should be evaluated alongside health data. Without this level of granularity, benefit adjustments remain incremental rather than strategic.
Within women’s health, coverage frequently remains episodic rather than longitudinal. Fertility benefits may exist without integrated maternal mental health support. Psychotherapy maximums may fall below the required amounts. Paramedical practitioners may exclude marriage and family therapists or social workers. Pelvic floor physiotherapy is often capped, hindering full effectiveness. Perimenopause support is rarely formalized, despite its intersection with cognitive performance, sleep stability, and musculoskeletal health. Expanding on these allows for preventive risk management rather than discretionary enhancement.
Plan design mechanics further influence outcomes, particularly in mental health coverage where continuity of care is often overlooked. This issue carries gendered implications. Women, who are more likely to seek mental health support and access outpatient services, may begin treatment through an employee and family assistance program (EFAP) only to encounter a structural interruption once the limited session allotment ends.
At that point, they must locate a new provider under the extended health plan, repeat their clinical history, and navigate waitlists during a period of vulnerability. For individuals, that disruption can stall progress and increase relapse risk.
Within this broader design framework, health and wellness spending accounts can add targeted flexibility without inflating insured premiums. When intentionally structured and clearly communicated, they can support services. However, flexible accounts should complement, not compensate for, gaps in core mental health coverage. Sustainable outcomes depend on coherent design, seamless transitions, and reduced friction across the entire care pathway.
Consultants who subscribe to best practices and continuous education will be able to comprehend and articulate data driven by insurance carriers in an ever-evolving industry. Coordinated reviews allow plan sponsors to identify and address escalating mental health claims, medication adherence challenges, and return-to-work gaps earlier. Integration reduces the fragmentation that prolongs claims.
Gender-neutral plan structures do not automatically produce equitable outcomes. Equal coverage does not guarantee equal access, nor does it ensure proportional risk mitigation. The financial implications of ignoring gender-differentiated health patterns are increasingly evident in national data and insurer reporting.
Plan sponsors, in conjunction with their consultants, analyze their experience rigorously, align benefits with predictable life-stage risks, and invest in preventive strategies position themselves to improve health outcomes while strengthening long-term workforce sustainability. The differentiator lies not in acknowledging gender differences but in responding to them with structural intention.
Taylor Valée, VP of client management and large client strategy at People Corporation, leads benefits strategy for Canada’s largest employers and teaches in leading industry certificate programs.
Jamil Jamal is a principal with People Corporation. Over the past 11 years, Jamal has co-instructed a course called Best Practices of Employee Benefits with Jeffrey Stinchcombe. He’s also a member of the advisory council for one of Canada’s leading insurance carriers.
