Canada's group benefits plans have expanded significantly over the past decade, adding virtual care, mental health support, and disease management programs. The number of resources available to employees has grown faster than the ability to make those resources feel like one coherent experience. Desjardins Insurance is responding by organizing coverage around the health situations employees actually face, not around insurance categories, and by pushing earlier into the before-diagnosis phase where, according to executive vice president Chantal Gagné, the industry still has the most ground to gain.
The fragmentation is partly structural. Insurance companies have traditionally built expertise around product lines and areas of coverage. That makes operational sense, but it can look very different from the other side of the plan. "When someone lives something, they don't live it by insurance categories," says Chantal Gagné, executive vice president, life and health insurance, Desjardins Insurance. "It really lives health because of a life event or a health issue." A benefits plan can become more comprehensive on paper while becoming harder for an employee to understand at the moment they need it most. More services alone do not solve that problem.
The Focus programs are a series of coordinated offerings built around specific health situations rather than specific benefit categories. Each one brings together benefits, professional advice, and access to external expertise within a single, coordinated experience, so a member does not have to identify and assemble the relevant pieces of their coverage on their own. Desjardins Insurance has launched Focus programs for cancer, family health, obesity, and mental health, and is preparing to add neurodiversity in November. Where a plan or a program falls short internally, external partnerships fill the space, whether that means specialized clinics, digital health providers, or condition-specific experts.
A plan member dealing with cancer may need medication, mental health support, physiotherapy, nutritional advice, and help managing an absence from work. Those services may already exist within a benefits plan, but they are often organized according to insurance categories rather than the health event that brought the person there in the first place. The Focus model reorients that. "You have cancer, here's what you may need," Gagné says. "All the resources are organized around the client's needs rather than insurance categories." The member does not have to determine independently which specialists to contact, which is where the coordination does its most practical work.
Gagné is direct. "The place where we should improve the most is the before-diagnosis phase," she says. That means reaching members before a health issue becomes more serious, rather than waiting until a diagnosis, claim, or absence creates an obvious point of intervention. Desjardins Insurance currently offers several programs built around earlier intervention. Its Health PACT service is designed to help employees stay at work through proactive intervention, while its EAP is intended to address personal problems before they interfere with work. The measurement challenge is real: an insurer can see when a prescription is filled or a disability payment is made, but isolating the value of an intervention that helped prevent a deterioration months or years later is far harder.
Gagné expects AI to change what is possible in both prevention and operating efficiency. "In the next 10 years, AI will probably bring lots of new capabilities to help us with prevention [and] also help us with the efficiencies of insurance companies," she says. She connects those efficiencies back to affordability. With medical costs rising, gains elsewhere in the system could help offset some of that pressure and support what she describes as an industry priority: keeping benefits plans sustainable. That link between AI-driven efficiency and plan affordability will matter most to employers already scrutinizing the value of each additional investment in their plans.
Many managers have never guided a team member through a serious health event. That gap is exactly what the Focus model is built to address. "The employer does not always have all the expertise it needs to support its employees," Gagné says. "It can rely on us to provide that support, not only for the employee but for the employer." The Focus model provides guidance on how to accompany a team member through a specific situation. It makes a complicated system feel simpler without pretending every employee will need the same thing, and it gives managers a clear place to turn when a situation exceeds their experience.
Gagné points to three possible returns. The first is engagement: better-supported employees may be more engaged in their work. The second is a swifter return to work, if employees can reach the right support earlier. The third is retention. "That's a powerful retention tool as well," Gagné says. A benefits experience that demonstrates support during a difficult period can influence how employees view their employer long after the immediate health issue has passed. Whether the Focus model can scale across the full range of conditions employees face will depend on execution over the next several years rather than on the concept itself. HR professionals looking for deeper analysis of Canadian group benefits strategy can explore it through Canadian HR Reporter's premium reports. If this is useful to your team, share it on Facebook, Twitter, or LinkedIn.
Chantal Gagné: executive vice president, life and health insurance, Desjardins Insurance.