New report finds benefit plans are leaving the sickest employees behind
Nearly half of Canadian workers live with at least one chronic condition, according to Statistics Canada, yet seven in ten say their benefits do not consistently help them manage it.
The gap between what plan members need and what they actually receive is the central finding of Living with Complexity: Navigating Chronic Care in Canada, a new report from Maple Corporation.
The Chronic Disease Prevention Alliance of Canada estimates chronic diseases cost the Canadian economy approximately $190bn annually in direct health-care costs and lost productivity.
The report argues that fragmented benefits coverage and an overburdened public system are making that figure worse, not better.
What employees are living with
Fifty-seven percent of employed respondents said they have missed work, reduced their hours or taken time off because of chronic condition-related needs.
Sixty-seven percent said managing care makes it harder to stay focused or productive.
Most working Canadians who disclose chronic pain, mental health issues, or autoimmune disorders face bias, unmet accommodations, or reduced career opportunities, a 2025 Health Partners Health Advisory Network survey found.
Another 21 percent chose not to disclose at all, fearing negative repercussions.
The mental health cost alone is substantial.
The Centre for Addiction and Mental Health estimates mental illness costs Canada more than $50bn per year in health-care costs, lost productivity and reduced quality of life.
The 2025 Benefits Canada Healthcare Survey found that heavy users of mental health benefits (89 percent), prescription drug benefits (83 percent) and chiropractic benefits (78 percent) were more likely to have at least one chronic illness.
ADHD represents the starkest case.
Just 9 percent of Canadians affected by the condition said the health-care system meets their needs — the lowest of any condition studied.
According to the Centre for ADHD Awareness, Canada, adults with ADHD are 61 percent more likely to have been fired, 33 percent more likely to be laid off and 53 percent more likely to quit than those without it. They also earn an average of 16 percent less than their peers.
Benefits are falling short
Although 71 percent of those with chronic conditions reported having health benefits beyond provincial coverage, only 26 percent said those benefits fully address gaps in care.
Forty-seven percent said benefits don't consistently help manage their condition, and 28 percent said they still face delays, long waits or gaps in access even with coverage.
Out-of-pocket costs compound the strain.
In the past 12 months, more women than men said they paid out of pocket for uncovered treatments across mental health conditions (69 percent vs. 55 percent), ADHD (73 percent vs. 56 percent), chronic respiratory diseases (67 percent vs. 53 percent) and heart disease or cardiovascular conditions (65 percent vs. 50 percent).
"There's nothing preventative or integrated about the current health-care ethos and often requires me to go to other practitioners and pay out of pocket for the care I actually need," one respondent wrote.
The broader system isn't filling the void.
Seventy-five percent of Canadians affected by a chronic condition told Maple's survey the public health-care system only sometimes or never meets their needs, with 83 percent saying care feels more reactive than proactive.
Eighty-five percent reported having to repeatedly share their medical history with different providers.
The caregiving cost employers overlook
Informal caregivers — employees supporting a partner, parent or child with a chronic condition — add another layer of workforce strain.
According to Statistics Canada, more than 7.8 million Canadians collectively provide 5.7 billion hours of unpaid care, valued at $97.1bn in economic output.
Seventy-six percent of those caregivers said they spend a substantial amount of time coordinating appointments and treatments; 79 percent said they cannot confidently access timely care for the person they support.
"Too great of a burden is placed on caregivers, who are given little to no support and are expected to carry on with their other responsibilities and work as if their lives were normal," wrote one respondent.
What the data says about solutions
Seventy-eight percent of respondents said consistent, 24/7 access to technology-enabled care would reduce the stress and time spent managing their condition.
Navigation and coordination support — helping employees route to the right provider, specialist or prescription without unnecessary delay — topped the list of new benefits that employees said they would use if available.
According to a Sun Life survey, 38 percent of those with diabetes and 35 percent of those living with obesity said they would use navigational services if offered.
The Canadian Institute for Health Information found that 13 percent of emergency department visits for rural and remote patients could potentially have been managed virtually, compared with 7 percent for urban patients — pointing to virtual care as a lever for both access and cost.
The report's central argument is that incremental improvements to existing benefit structures will not be enough.
Moving coverage beyond episodic models, expanding access to mental health and allied health supports and reducing out-of-pocket costs are the changes it says will actually close the gap.
Maple co-founder and CEO Brett Belchetz said new research confirms what patients and partners have "long understood" about demand for care that fits how people actually live.
Survey methodology: Maple Corporation conducted the survey from March 4 to 9, 2026 among 1,526 online Canadians aged 18 and older, balanced on age and region, who are members of the Angus Reid Forum. Margin of error: +/- 2.5 percentage points, 19 times out of 20.
