Generic Ozempic Is Here. Will Your Drug Plan Actually Save Money?

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Generic Ozempic Is Here. Will Your Drug Plan Actually Save Money?

If drug costs have been climbing on your group benefits plan, GLP-1 medications like Ozempic are likely part of the reason. These drugs have been among the fastest-growing cost drivers in employer-sponsored plans across the country. So when Health Canada approved a generic version of semaglutide, the active ingredient in Ozempic, on April 28, 2026, and a second generic followed in early May, it was welcome news for anyone managing a group drug plan. Canada was the first G7 country to approve a generic semaglutide.

But here is the thing: lower costs are not guaranteed just because a cheaper version of the drug exists. Whether your plan actually sees savings depends almost entirely on how it is designed.

What Happens When a Drug Goes Generic?

When a brand-name drug loses patent protection, other manufacturers can produce and sell equivalent versions at a lower cost. The savings can be significant.

As a rule of thumb in the industry, when one or two generics enter the market, prices may fall by 20 to 30 per cent below the brand-name drug. With more generics competing over time, those discounts can deepen further. These are general industry estimates, and actual outcomes will vary.

For Ozempic specifically, this could translate to roughly one to two per cent savings on a plan’s total drug costs. That may sound modest, but for organizations with meaningful Ozempic spend, it adds up quickly, especially at renewal.

Why Savings Do Not Happen Automatically

Here is where many plan sponsors get caught off guard: the existence of a generic does not mean your plan will automatically pay for it at the lower price.

Without specific plan design provisions in place, many members may stay on the brand-name drug. Their doctor prescribed it. They have been taking it. They may not even know a generic exists. And if your plan covers it without any substitution requirement, there is little reason to switch.

The result is a plan that may continue paying brand-name prices for a drug that now has a lower-cost equivalent on the market.

What Plan Sponsors Can Do Right Now

The arrival of generic Ozempic creates a real window to act, but it requires a conversation with us. Here are the three areas worth reviewing:

Generic substitution policies. Many plans already have mandatory substitution clauses that require members to use a generic when one is available, unless there is a medical reason not to. If your plan does not have this in place, or if it only applies to certain drug categories, now is the time to review it. Adding generic substitution for GLP-1 medications could meaningfully reduce what the plan pays.

Prior authorization requirements. Prior authorization means a member needs approval before the plan will cover a specific drug. This is particularly useful for high-cost medications where clinical criteria should be confirmed before coverage is granted. It also creates a natural point to direct members to the generic option. If your plan does not currently require prior authorization for GLP-1 medications, that is worth exploring with your insurer.

Brand-name pricing negotiations. In some cases, insurers may be able to negotiate pricing directly with brand-name drug manufacturers. This is not a standard plan-design feature, but it is worth asking your insurer whether it is an option and whether brand-name semaglutide pricing is available through their arrangements. If it is available, it could help reduce costs even for members who remain on the brand-name drug for medical reasons.

The Bigger Picture on Plan Design

Generic Ozempic is a useful reminder that drug plan management is not a set-it-and-forget-it exercise. Small design decisions, like whether a plan has a substitution clause or a prior authorization requirement for high-cost drugs, can translate into real, measurable differences in cost over time.

For organizations that have seen drug costs climb in recent years, this is a meaningful opportunity. The savings potential is real. Whether your plan captures it depends on reviewing your plan design and having a conversation with us before your next renewal.

This content is provided for general informational purposes only. It is not intended to provide investment, tax, or legal advice, and should not be relied upon as such.

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What Happens to Your Group Benefits When You Leave a Job?

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What Happens to Your Group Benefits When You Leave a Job?

Leaving a job, whether by choice or by circumstance, brings a long to-do list. Updating your resume, signing new paperwork, figuring out your finances. One item that often gets missed in the shuffle: your group benefits.

For many Canadians, employer-provided health, dental, vision, and life insurance coverage quietly disappears the moment they leave. Here is what actually happens, what your options are, and what steps to take so you do not end up without coverage when you need it most.

When Does Coverage End?

The exact end date depends on your employer’s plan, but most group benefits plans terminate coverage on one of two dates:

  • The last day of active employment, meaning your coverage ends the day you stop working.

  • The last day of the month in which you stop working, which gives you a short buffer.

Your employee handbook or HR contact can confirm which applies to your plan. If you are being laid off or terminated, sometimes an employer will extend benefits for a defined period as part of a severance arrangement, this should be spelled out in any severance agreement you receive. In some provinces, such as British Columbia, employees who are laid off may also have the option to voluntarily continue their coverage for up to six months by paying the premiums themselves.

The takeaway: do not assume coverage continues past your last day. It usually does not, and even a brief gap can leave you on the hook for expenses.

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What Coverage Goes With You, and What Disappears

Not all group benefits disappear the same way. Here is what typically happens with each type:

Health and dental: These end on your termination date (or end of month, depending on the plan). Most plans include a run-off period, typically 30 to 90 days, to submit claims for services you received while you were still covered. Any claims for services after your termination date will be denied. Before you leave, it is worth getting any outstanding treatments done and filling any prescriptions. Some insurers also offer conversion options for extended health and dental coverage within 60 to 90 days of losing group coverage, though this is less common than life insurance conversion.

Vision: Same as health and dental, coverage ends, and unused benefit maximums do not transfer.

Life insurance and accidental death and dismemberment (AD&D): Group life insurance through your employer is usually converted to an individual policy without medical evidence through a feature called the conversion privilege. This is one of the most important and least-known options available to departing employees.

Short-term and long-term disability: These stop when employment ends. You cannot claim disability benefits from a former employer’s plan after your last day. If you are already on a disability claim when you leave, the rules get more specific, check your plan documents.

Employee Assistance Programs: These end at termination as well.

The Conversion Privilege: A Rarely Used but Valuable Option

Most group life insurance plans come with a conversion privilege, the right to convert your group life coverage to an individual permanent life insurance policy without providing evidence of insurability. That means no medical questions, no physical exam.

There is a catch: you typically have only 31 days from the date your group coverage ends to exercise this option. Miss that window, and you lose it.

The converted policy will cost more than your group coverage did. Group rates are typically lower because the risk is pooled across all employees. An individual policy reflects your age and the fact that the insurer cannot screen for health. But for someone who has developed a health condition during employment and would otherwise have difficulty qualifying for individual coverage, this option is a lifeline.

Contact your former employer’s benefits administrator or the insurer directly to find out the exact deadline and how to start the conversion process.

Your Options for Replacing Health and Dental Coverage

Once your group plan ends, you have a few paths to replacing health and dental coverage:

A spouse or partner’s plan. If your partner has their own employer plan, losing your group coverage is typically considered a qualifying life event that allows them to add you immediately, without waiting for an open enrollment period. Act within 30 to 60 days of your coverage ending, as most plans require prompt notification.

Individual health and dental insurance. Insurance companies offer individual health and dental plans that you can apply for on your own. Premiums are higher than group rates, and pre-existing conditions may not be covered, but this option fills the gap if no group plan is available to you. Many providers allow applications within 60 days of losing group coverage to waive certain waiting periods.

Professional or industry associations. Some professional groups, engineers, teachers, freelancers, offer group benefit plans to members at better rates than individual plans. If you belong to or qualify for membership in an association, this can be worth exploring.

What to Do Before Your Last Day

A few practical steps to take before you walk out the door:

Get a copy of your benefits booklet or summary plan document. This outlines exactly what your plan covers, how conversion works, and the deadlines involved. HR should be able to provide this.

Use what you can before your coverage ends. Book that dental cleaning, fill outstanding prescriptions, and pick up any medical supplies covered under your plan. Most people leave money on the table simply by not timing this properly.

Clarify your exact termination date for benefits purposes. Ask HR explicitly whether benefits end on your last day worked or at the end of that month.

Check the conversion privilege deadline. If you have any concern about qualifying for individual life insurance, find out your deadline immediately and do not let it pass.

Notify your partner’s employer. If you plan to join your partner’s group plan, they need to notify their plan administrator within the required window, typically 30 to 60 days.

The Gap You Do Not Want

Going without health and dental coverage for even a short time can be expensive. A single dental emergency, a course of prescription medication, or a specialist visit that falls outside provincial coverage can cost hundreds to thousands of dollars out of pocket.

The good news is that a gap does not have to happen. With a bit of planning and quick action after your last day, you can move from one source of coverage to another without interruption.

Have questions about your coverage options? We are here to help. Reach out to our team and we will walk you through what makes sense for your situation.

This content is provided for general informational purposes only. It is not intended to provide investment, tax, or legal advice, and should not be relied upon as such.

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Helping Employees Get the Most Out of Their Health Benefits

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Helping Employees Get the Most Out of Their Health Benefits

You can provide the most generous benefits package in the world, but if employees don’t understand how to use it, it won’t have the impact you hoped for. Across Canada, many employees leave valuable health and wellness resources untapped simply because they don’t know what’s available or how to access it. For business owners and HR professionals, educating employees about their benefits isn’t just a nice extra—it’s an essential step toward creating a healthier, more loyal, and more productive workforce.

When Benefits Go Unused, Everyone Misses Out

Offering benefits is a major investment. Extended health coverage, dental care, paramedical services, and wellness allowances all come with costs to the company. When employees fail to take advantage of these resources, it’s not only a missed opportunity for them—it’s also a lost return on investment for the organization.

Imagine a scenario: an employee suffers ongoing back pain but doesn’t realize physiotherapy is covered under your plan. They avoid treatment, their pain worsens, and productivity drops. Months later, a preventable issue becomes a bigger concern that impacts both their well‑being and your team’s efficiency. This is what happens when benefits are underused—they don’t provide the intended health, morale, or retention impact.

Educating employees ensures they view benefits not as fine print in a handbook but as tools to support their daily lives. A team that knows how to access preventative health care, mental health services, and family coverage options is a team that stays healthier and feels more valued.

Why Health Benefits Education Can Be Challenging

Despite the clear value, helping employees understand health benefits often comes with hurdles.

Information overload on day one: New hires receive a mountain of onboarding materials. By the time they get to the benefits booklet, attention and energy are running low.

Confusing terminology: Words like “deductible,” “co‑insurance,” or “coordination of benefits” are not part of everyday language. Without translation into plain English, many employees tune out.

Irregular communication: Many organizations only discuss benefits once a year during open enrollment. Without reminders or ongoing conversations, details fade quickly.

Reactive awareness: Employees often learn about benefits only when a medical issue arises. By then, stress and urgency can make it harder to absorb new information.

Turning Health Benefits into Everyday Value

Clear and consistent communication helps employees view their benefits as practical tools rather than abstract policies. Here are strategies to bring health benefits to life:

Break information into small, digestible pieces
: Instead of a single benefits session, share one feature at a time. For instance, start with paramedical coverage one month, mental health supports the next, and vision care later. This keeps information approachable and memorable.

Use relatable examples
: Paint a picture of real-life use. “If your child needs braces, our dental plan can cover 50% of the cost up to $2,000” is easier to grasp than a page of percentages and annual maximums. Stories connect the benefit to employees’ daily lives.

Incorporate wellness education into your culture
: Lunch‑and‑learns, wellness newsletters, or quick “Did you know?” messages in internal chats can keep health resources top of mind. The goal is to normalize talking about benefits as part of workplace well‑being.

Highlight preventative care
: Preventative services—like annual eye exams, physiotherapy after minor strains, or mental health counselling—often save employees and employers from bigger issues down the road. When staff understand that benefits support staying healthy, not just reacting to illness, they’re more likely to use them proactively.

Offer multiple ways to learn
: Some employees prefer reading a guide, others learn best through short videos, and some want to ask questions in a small group session. A mix of formats ensures the message reaches everyone.

Measuring the Impact of Your Efforts

It’s important to know whether your education efforts are working. Instead of guessing, consider these approaches:

Track utilization rates for paramedical services, wellness allowances, and mental health support. An increase often reflects better awareness.

Monitor enrollment levels for optional coverage, such as enrolling in optional critical illness protection.

Collect employee feedback via short surveys to gauge confidence in understanding their benefits.

Watch for retention improvements and fewer sick days, as engaged employees tend to stay longer and take a more proactive approach to their health.

Even small increases in understanding can create noticeable improvements in morale and the return on your benefits investment.

When employees know their benefits, they feel supported. When they use those benefits, they’re healthier, happier, and more productive. And when they see their workplace investing in their well‑being, loyalty naturally grows.

Helping employees understand their health benefits is an ongoing effort, not a single presentation. If your organization hasn’t revisited how benefits are communicated, this is a perfect time to start. A clear, proactive education strategy can turn an underused expense into a meaningful tool for engagement and wellness.

We can help you create a tailored communication strategy to educate your team, improve benefit utilization, and strengthen employee loyalty.

Disclaimer: This article is for informational purposes only and does not constitute financial, legal, or tax advice. Always consult a qualified professional regarding your specific situation. We are not responsible for any actions taken based on this content.

Group Insurance vs Individual Life Insurance

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Group Insurance vs Individual Life Insurance

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“I already have life insurance from work, so why do I need to get it personally?” or “Work has got me covered, I don’t need it.”

While it’s great to have group coverage from your employer or association, in most cases, people don’t understand that there are important differences when it comes to group life insurance vs. self owned life insurance.

Before counting on insurance from your group benefits plan, please take the time to understand the difference between group owned life insurance and personally owned life insurance. The key differences are ownership, premium, coverage, beneficiary and portability.

Ownership:

  • Self: You own and control the policy.
  • Group: The group owns and controls the policy.

Premium:

  • Self: Your premiums are guaranteed at policy issue and discounts are available based on your health.
  • Group: Premiums are not guaranteed and there are no discounts available based on your health. The rates provided are blended depending on your group.

Coverage:

  • Self: You choose based on your needs.
  • Group: In a group plan, the coverage is typically a multiple of your salary. If your coverage is through an association, then it’s usually a flat basic amount.

Beneficiary:

  • Self: You choose who your beneficiary is and they can choose how they want to use the insurance benefit.
  • Group: You choose who your beneficiary is and they can choose how they want to use the insurance benefit.

Portability:

  • Self: Your policy stays with you.
  • Group: Your policy is tied to your group and if you leave your employer or your association, you may need to reapply for insurance.

Talk to us, we can help you figure out what’s best for your situation.

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Exploring the Value of Group Benefit Plans for Your Employees

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In today’s ever-evolving workplace landscape, employees place a premium on several key factors:

1. Alignment with employer values, especially sustainability.

2. Achieving a harmonious work-life balance.

3. Assistance in coping with the rising cost of living expenses.

4. Opportunities for delayed retirement.

5. Cultivating a sense of belonging within the workplace.

6. Flexibility in terms of work hours and location.

7. Ensuring job security.

If your business is experiencing growth and you’re considering adding group benefit plans to your employee offerings, you’re in the right place. We understand the importance of providing the right employee benefits solution for your business.

Understanding Group Benefit Plans and Their Value

Group benefit plans form a crucial part of a company’s total compensation package, available to employees regardless of their seniority, position, or qualifications. These plans often encompass medical coverage for employees and their dependents. While it may seem like an additional expense during a period of growth, offering employee insurance benefits is essential for the long-term sustainability of your business.

So, why should your company consider offering group insurance benefits? Here are some compelling reasons:

1. Convenience: Group insurance benefits simplify healthcare coverage for your employees and their families.

2. Workforce Protection: These benefits provide a safety net for your staff, promoting their well-being.

3. Staff Retention: Offering benefits can help you retain valuable employees, reducing turnover.

4. Tax Benefits: Group insurance plans offer tax advantages for both employers and employees.

5. Customization: Plans can be tailored to meet your business’s unique needs.

6. Morale Boost: Providing benefits can boost productivity and morale among your workforce.

What’s Covered by Group Insurance Plans?

Group insurance plans typically cover medical-related expenses that provincial healthcare plans might not fully address. This coverage can include paramedical and ambulance services, dental care, eye care, hospital stays, and certain prescription drugs. Additionally, you have the option to combine group benefits plans with retirement and savings plans.

Types of Group Benefits Plans

Various types of group benefits plans are available, each catering to different company needs and preferences. The most popular options include:

1. Fully-Insured

2. Self-Funded

3. Level-Funded

No matter the size of your business, there’s a group insurance benefit plan that suits your needs. We offer flexible and innovative plans that anticipate your requirements. Our services aim to reduce your administrative workload, allowing you to focus on critical aspects of your business.

Is Group Insurance Cost-Effective?

One of the financial advantages of group insurance is lower premiums while maintaining coverage equivalent to individual health insurance. Typically, employers cover most of the group benefit plan costs, with employees contributing a small percentage of their salary towards the monthly premium. If you’re concerned about the tax implications of providing benefits at work, it’s advisable to with us for specific details.

In conclusion, offering group benefit plans is a strategic move to attract and retain top talent while promoting employee well-being and financial security. Whether you have a small or large business, we are here to assist you in finding the right plan that aligns with your organization’s needs and objectives.

Understanding Target Loss Ratio and Your Group Benefits Plan

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Group benefits can be intricate both in their establishment and administration. There are numerous details and considerations to be aware of when purchasing a group benefits plan, one of which is the target loss ratio (TLR).

Key Questions Addressed:

  • What is a target loss ratio?

  • How does my TLR influence my premiums upon policy renewal?

  • What steps should I take if I have concerns regarding my TLR?

Understanding Target Loss Ratio (TLR):
Here are the primary aspects you should understand about the target loss ratio (TLR):

  • It represents the expected profit point of your employee benefit plan’s comprehensive health and dental benefits.

  • TLR is the maximum dollar amount of claims paid by the insurance company, expressed as a percentage of your premium. For instance, if an insurance company pays $40 in claims for every $80 collected in premiums, the loss ratio stands at 50%.

  • The TLR is primarily determined by two factors: the number of members participating in the employee benefit plan and the annual premium paid.

  • The loss ratios can vary based on the type of insurance. For instance, the loss ratio for property insurance is typically lower than that for health insurance.

Does my TLR Affect My Premiums Upon Renewal?
Generally, your TLR won’t have a significant influence on your premiums when renewing. However, a notable increase or decrease in the number of staff members participating in your group benefits plan might cause some impact.

Other factors influencing your renewal premiums include:

  • A substantial amount of health and dental claims made.

  • Changes in the general demographics of your employees, such as aging.

  • An increase in the cost of services covered by your group benefits plan.

  • General inflation.

Addressing Concerns About TLR:
As someone overseeing a group benefits plan, your objective is to ensure optimal value for your premium expenditure.

If you’ve been collaborating with the same insurance provider for an extended period, it’s beneficial to explore other available options. Comparing offerings can help ascertain if the rate and TLR you’re being offered align with current market standards.

It’s essential to consider how varying TLRs might influence the long-term viability of your group benefits plan. If you’re keen on gaining deeper insights, consider reaching out to industry experts or consultants for guidance.

Insurance Planning for Business Owners

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For business owners, making sure your business is financially protected can be overwhelming. Business owners face a unique set of challenges when it comes to managing risk. Insurance can play an important role when it comes to reducing the financial impact on your business in the case of uncontrollable events such as disability, critical illness or loss of a key shareholder or employee.

This infographic addresses the importance of corporate insurance.

The 4 areas of insurance a business owner should take care of are:

  • Health

  • Disability

  • Critical Illness

  • Life

Health: We are fortunate in Canada, where the healthcare system pays for basic healthcare services for Canadian citizens and permanent residents. However, not everything healthcare related is covered, in reality, 30% of our health costs* are paid for out of pocket or through private insurance such as prescription medication, dental, prescription glasses, physiotherapy, etc.

For business owners, offering employee health benefits make smart business sense because health benefits can form part of a compensation package and can help retain key employees and attract new talent.

For business owners that are looking to provide alternative health plans in a cost effective manner, you may want to consider a health spending account.

Disability: Most people spend money on protecting their home and car, but many overlook protecting their greatest asset: their ability to earn income. Unfortunately one in three people on average will be disabled for 90 days or more at least once before the age of 65.

Consider the financial impact this would have on your business if you, a key employee or shareholder were to suffer from an injury or illness. Disability insurance can provide a monthly income to help keep your business running.

Business overhead expense insurance can provide monthly reimbursement of expenses during total disability such as rent for commercial space, utilities, employee salaries and benefits, equipment leasing costs, accounting fees, insurance premiums for property and liability, etc.

Key person disability insurance can be used to provide monthly funds for the key employee while they’re disabled and protect the business from lost revenue while your business finds and trains an appropriate replacement.

Buy sell disability insurance can provide you with a lump sum payment if your business partner were to become totally disabled. These funds can be used to purchase the shares of the disabled partner, fund a buy sell agreement and reassure creditors and suppliers.

Critical Illness: For a lot of us, the idea of experiencing a critical illness such as a heart attack, stroke or cancer can seem unlikely, but almost 3 in 4 (73%) working Canadians know someone who experience a serious illness. Sadly, this can have serious consequences on you, your family and business, with Critical Illness insurance, it provides a lump sum payment so you can focus on your recovery.

Key person critical illness insurance can be used to provide funds to the company so it can supplement income during time away, cover debt repayment, salary for key employees or fixed overhead expenses.

Buy sell critical illness insurance can provide you with a lump sum payment if your business partner or shareholder were to suffer from a critical illness. These funds can be used to purchase the shares of the partner, fund a buy sell agreement and reassure creditors and suppliers.

Life: For a business owner, not only do your employees depend on you for financial support but your loved ones do too. Life insurance is important because it can protect your business and also be another form of investment for excess company funds.

Key person life insurance can be used to provide a lump sum payment to the company on death of the insured so it can keep the business going until you an appropriate replacement is found. It can also be used to retain loyal employees by supplying a retirement fund inside the insurance policy.

Buy sell life insurance can provide you with a lump sum payment if your business partner or shareholder were to pass away. These funds can be used to purchase the shares of the deceased partner, fund a buy sell agreement and reassure creditors and suppliers.

Loan coverage life insurance can help cover off any outstanding business loans and debts.

Reduce taxes & diversify your portfolio, often life insurance is viewed only as protection, however with permanent life insurance, there is an option to deposit excess company funds not needed for operations to provide for tax-free growth (within government limits)  to diversify your portfolio and reduce taxes on passive investments.

Talk to us about helping making sure you and your business are protected.

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10 Essential Decisions for Business Owners

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10 Essential Decisions for Business Owners

Business owners are busy… they are busy running a successful business, wearing lots of hats and making a ton of decisions. We’ve put together a list of 10 essential decisions for every business owner to consider; from corporate structure to retirement and succession planning:

  • Best structure for your business (ex. Sole Proprietor, Corporation, Partnership)

  • Reduce taxes

  • What to do with surplus cash

  • Build employee loyalty

  • Reduce risk

  • Deal with the unexpected

  • Retire from your business

  • Sell your business

  • Keep your business in the family

  • What to do when you’re retired

As a financial advisor, we are uniquely positioned to help business owners, talk to us about your situation and we can provide the guidance you need.

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