My friend Tania was recently diagnosed with breast cancer. While dressing for work, she noticed something didn’t look right. Then she felt it —a tiny, stony presence beneath her skin. Weeks later, Tania had her diagnosis and treatment plan confirmed for breast cancer—surgery, chemo and radiation, and this involved months off work.

Tania’s benefits plan includes a long-term disability (LTD) benefit that came with a 90-day waiting period. With no short-term disability coverage, she applied for Employment Insurance (EI) disability benefits. EI is designed to pay 55% of your average weekly insurable earnings to a maximum weekly benefit of $695 in 2025. With only EI disability benefits, no Short-Term Disability (STD) and no Critical Illness coverage at her company, Tania was forced to use all of her emergency savings just to cover her mortgage, groceries, car payments and other monthly bills before her first LTD payment arrived, as the EI benefits were simply not sufficient to cover all her expenses.

When the LTD payments finally started, Tania expected to receive 67% of her gross salary. However, because her employer paid 100% of the premiums, her benefit was taxable income. She was unaware of the impact of her LTD benefit amount exceeding the Non-Evidence Maximum (NEM) within her group benefits plan. NEMs are the highest amount an employee can be granted without additional medical questions. To receive benefits in line with her expectations, Tania should have submitted medical information to be reviewed by the insurance company to decide if she was approved for the additional coverage above the guarantee amount or NEM. After tax withholdings and as a result of the lower NEM, Tania’s 67% protection felt more like 45% of her take-home pay.

While Tania was off work getting treatment, she also noticed that there were new expenses she didn't have before—more travel to doctors’ appointments, and her partner also had to take time off work to go to some appointments with her. Her workplace had a drug and health plan; however, there were still out of pocket expenses for some drugs and counselling support as coinsurance was less than 100%.

Suddenly, her safety net seemed far less safe. Financial surprises and unexpected medical bills caused Tania’s anxiety to spike, which slowed her recovery. When I spoke to her last week, she was trying to cope with both the physical effects of her cancer treatment, and the mental stress of worrying about her health.

Tania’s story is about a financial and psychological collision. In 2025 alone, over 250,000 Canadians were diagnosed with cancer—nearly half of them in their prime working years.¹

While 85% of survivors return to work within four years, ² they often face a recovery penalty, earn approximately 10% less than their peers due to missed milestones and reduced capacity and missed career milestones in the first few years.³

The systemic cost of cancer to Canada has hit $38 billion, including costs for absenteeism and presenteeism (working while unwell) in 2024.⁴ To protect both your people and your bottom line, your benefits strategy must move from reactive to resilient.

Building a better safety net with group benefits

Research indicates that Canadian employers’ workplace benefits may have opportunities in these areas:

1. Disability support for the underinsured

EI sickness benefits has a low benefit cap of 55% of insurable earnings and doesn't allow for the gradual, part-time return-to-work that cancer recovery often requires. Standard Short-Term Disability (STD) and Long-Term Disability (LTD) plans are essential for wage replacement. When a benefit plan includes LTD or STD, the employer has an important administrative responsibility to ensure employees understand the NEMs as an organization's highest earners may be significantly under-insured. If an employee is entitled to $5,000/month based on their salary, but the NEM is $3,000, they will only receive $3,000 unless they have submitted medical information that has been approved by their insurer.

While STD and LTD are an essential support for an employee, they are not designed to cover the non-wage expenses associated with serious illness. When employees face out-of-pocket costs—such as prescription drugs not covered by public plans, coinsurance amount for drugs, travel for treatment, or home care—they may face financial challenges. This financial strain frequently forces a premature return to work, which compromises the recovery process and leads to long-term productivity loss. ⁴

2. Helping SMEs navigate the disability landscape

While small to medium size enterprises (SME) prioritize their workforce, they may face challenges in maintaining the HR infrastructure required to manage complex disability cases. When a benefit plan has STD and LTD, the SME gains valuable access to help navigate an employee away on disability:

• Rehabilitation: Insurance carriers often provide vocational rehab, ergonomic tools and knowledge.
• The recovery toolkit: Our claims managers use specialized tools to manage the transition some of these tools include:
  • The Claim Lab: A 360-degree questionnaire to understand the biological and social factors impacting work so we can better deliver the right support at the right time.
  • TiCBT: A 12-week, therapist-guided digital program to manage anxiety and the fear of recurrence.
  • Medical Confidence: Healthcare navigation that can help members navigate to the soonest available appointment with a specialist to reduce wait times.
  • Pharmacogenomics: Data-driven testing to ensure mental health medications are effective, potentially accelerating recovery from anxiety or depression.
• Sustained support: Where support often drops after the initial return, we provide employers with tips for continuous check-ins and tailored accommodations.

3. Supporting oral oncologic drugs coverage

Not all Canadian provinces have universal public coverage for oral oncology drugs. Depending on the province, coverage is generally limited to specific eligible groups, such as seniors, individuals on social assistance, or those with low incomes. Here are some examples of the differences:

• Provinces cover intravenous cancer drugs administered in hospitals or cancer centers.
• BC, AB, SK, MB: Cover both hospital-administered and ambulatory cancer therapies (oral or injectable) at 100%.
• ON, QC, Atlantic: Typically cover only hospital-administered drugs. At home cancer therapies drugs often require private insurance or enrollment in provincial drug plans

If a benefits plan does not have extended health benefits, the employee’s path to accessing oral oncology drugs becomes significantly more complex and often results in out-of-pocket costs. Even with government help, employees often face hidden costs such as dispensing fees charged for every prescription and ancillary drugs for nausea or pain that may not be covered.

4. Mental health support

While many employers offer flexible hours, medical leaves, and disability coverage, there is an opportunity to go further by supporting the emotional journey, helping employees navigate stigma and find peace of mind regarding their job security. ⁵

78% of cancer survivors experienced at least one emotional concern 1-3 years post cancer treatment.⁶ Furthermore, the transition back to work often highlights a critical reintegration gap where formal support structures vanish just as the psychological burden shifts.⁷ Employers can’t assume that an employee being in remission or finishing treatment equates to a return to normalcy, and sometimes overlook the long-term impact of trauma and persistent fatigue.

Without tailored resources—such as psycho-oncology counselling, peer support networks, or manager empathy training—employees are at a higher risk for burnout and isolation. Untreated mental health struggles among cancer survivors are a primary driver of absenteeism, lost productivity, and higher turnover rates.⁸

Whole-person care: Integrated cancer support

The support to employees suffering cancer must address the full spectrum of an employee's needs—physical, mental, and financial well-being.

1. Drug coverage: Closing the oral oncology drug cost gap

More than half of newly developed oncology drugs are in oral formulations taken at home. Since these are not administered in the hospital, they often fall outside public funding and require reliance on private group health plans.⁹ Extended health benefits (EHB) plans can help bridge that gap for plan members and provide access to expensive oncology drugs as well coverage for ancillary medicine for nausea and pain. Beyond the physical challenges, patients carry the heavy emotional load of coordinating care and facing uncertainty. The ability to take the medication they need at home helps to lessen the number of hospital visits, which can have a real impact on overall quality of life.

2. Psychosocial support: Beyond the physical

A successful recovery is often dictated by an employee’s mental health. To support the whole person, organizations must bridge the gap between clinical treatment and workplace culture.

• People leadership: Managers are the forefront of the employee experience. Implementing training to teach empathetic communication ensures managers focus on functional limitations and privacy, rather than the diagnosis itself.
• Specialized counselling: Through our EAP AssistNow, we provide access to counselors experienced in oncology. This helps employees and their families navigate the complex emotional landscape and the logistics of the healthcare system.
• Navigation services: Avoid access confusion by leveraging a benefits navigator as a single point of contact to facilitate access to mental health services from multiple providers. For example, our Mental Health Navigator guides individuals through the complexities of the mental health system and towards effective treatment options tailored to their unique needs.
• Second medical opinion: Receiving a cancer diagnosis is often a traumatic event that triggers a sense of lost control. A second medical opinion acts as a psychological anchor, providing clarity that can significantly reduce the weight of uncertainty. Teladoc Medical Experts service provides an expert review of an existing diagnosis or treatment plan, using specialists across a global network to give the employee clarity and recommendations.

3. Addressing the out-of-pocket burden

Financial stress is a physical drain. While traditional benefits play a vital role in covering the medical treatment, patients also face additional day-to-day financial demands such as travel, home care and specialized equipment.

• Critical Illness (CI) coverage: CI as a vital financial stabilization tool. It provides a tax-free lump sum payment upon diagnosis, offering the immediate capital needed to cover out-of-pocket costs. This allows the survivor to focus entirely on recovery rather than debt. Employers can add CI as mandatory or voluntary benefit.
• Tiered payouts: Enhanced CI modernizes coverage by replacing the traditional “all-or-nothing” model with greater flexibility. By offering partial payouts (e.g., 10%) for early-stage diagnoses—such as Ductal Breast Carcinoma in Situ (DCIS) or early-stage prostate cancer—employers can provide meaningful financial support that aligns with the ability of new screening technologies to detect illness sooner.
• EHB can cover:
  • Wigs, prosthetics and mobility aids under Medical Supplies/Devices
  • Paramedicals to cover physiotherapy, massage therapy, dieticians
  • Semi-private or private hospital rooms
  • Private nurse
  • Ambulance

4. Structured Return-to-Work (RTW)

Returning to work is not a straight line. Recovery from chemotherapy or radiation often involves invisible symptoms like cognitive dysfunction and overwhelming fatigue.

Standard policies may not support a gradual return to work, typically categorizing employees as either fully active or fully disabled. Empire Life’s Partial Disability Clause allows for a phased return; employees can work reduced hours while combining wages and proportional benefits to maintain nearly 100% of their pre-disability income.

Our disability management practice is built upon three core pillars:

1. Innovation through research: We engage in continuous research to streamline and improve disability management outcomes.
2. Expert, compassionate case management: Our team is defined by their passion and dedication. We take an involved approach, ensuring every member is treated with the highest level of dignity, empathy, and respect.
3. Proactive communication and support: We bridge the gap between employers and employees by maintaining consistent transparency. By ensuring all parties know exactly what to expect, we foster an environment where everyone feels genuinely supported.

5. Prevention: Reducing future risk

By addressing modifiable risk factors and investing in early detection before symptoms arise, employers can move beyond simply managing illness toward a proactive strategy that protects both the employee's health and the company’s bottom line.

Investing in prevention is the most cost-effective long-term strategy for reducing the societal burden of cancer.¹⁰ Up to 40% of cancers in Canada are attributable to modifiable risk factors, strategic investments in proactive health management can yield quantifiable returns.¹¹

6. Early testing and screening

Canada’s public health plans provide essential screenings for breast, cervical, and colorectal cancers. It is also encouraging to see the emergence of specialized diagnostic innovations such as Multi-Cancer Early Detection (MCED) tests (e.g., the Galleri test), precision biomarker testing, and liquid biopsies now entering the market, providing valuable new avenues for detection that enhance the traditional screening ecosystem. ¹²

The table below outlines some intervention mechanisms: