Is Your Benefits Plan Meeting Today’s Mental Health Needs?

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Many Employee Assistance Programs (EAPs) now include virtual counselling, digital tools and wellness resources, making them a practical and affordable starting point for workplace mental health support.

But with therapy costs rising and needs extending beyond a few sessions, more employers are questioning whether their coverage still reflects today’s reality.

Across Canada, demand for mental health support continues to grow. Data shows Canadians’ self-rated mental health has worsened over the past decade, and the need for care is rising, even as many face cost and access barriers when they try to get help. 

At the same time, the cost of counselling has increased. In many Canadian cities, therapy sessions can range from $150 to more than $200 per hour, which means employees can run through coverage quickly.

The Role of an Employee Assistance Program (EAP)

An EAP provides short-term counselling, crisis support and referrals to community services.

Many programs now also include virtual counselling sessions, phone-based support and online mental health tools, making it easier for employees to access care quickly and privately.

For employees dealing with stress, relationship issues, burnout or financial pressure, an EAP can be an important first step. For many small and mid-sized employers, it also provides a practical way to offer mental health support while managing benefits costs.

EAP counselling is typically limited to a small number of sessions. Employees who need ongoing therapy may need additional coverage through their group benefits plan, especially as expectations evolve around access to care, as explored in the mental health benefits your team wants.

When Coverage Runs Out

Many group benefits plans cover mental health counselling under paramedical benefits such as psychologists, social workers or psychotherapists.

But coverage levels vary widely by employer and plan design. Basic plans often cap mental health coverage in the $300 to $500 per-year range, with some plans extending into the low thousands. At typical private-practice rates of around $150 to $200 per session, that may translate into well under five covered visits per year for many employees. 

When employees reach their limit, many stop treatment rather than pay out of pocket. One survey found over a third of plan members in poor mental health stopped treatment until the new benefits year once their maximums were reached.

Why Employers Are Taking A Closer Look

Mental health has become one of the most significant drivers of workplace health costs.

Claims related to mental health conditions have increased sharply in recent years. Some reports estimate mental health claims are more than 130 per cent higher than before the pandemic.

At the same time, financial barriers still prevent many Canadians from accessing care, with 82 per cent of heavy users of mental health therapy saying coverage limits curtail their treatment plans. 

For employers, this creates a difficult gap. Without affordable access to care, employees may delay treatment, struggle with productivity or eventually require disability leave.

How Employers Can Strengthen Mental Health Benefits

Organizations that want to build on their EAP foundation are exploring several options. Some are increasing counselling maximums so employees can access more therapy sessions each year. Others are introducing a dedicated mental health maximum, separate from other paramedical services such as massage therapy or physiotherapy.

Virtual care is also expanding across Canadian benefits plans. Many insurers now provide access to licensed therapists through secure digital platforms, which can help reduce wait times and improve access for employees in smaller communities.

Some employers also add a Health Care Spending Account (HCSA) so employees can use additional funds if counselling costs exceed standard plan limits.

The Most Accessible Place to Start

An EAP is a valuable foundation for workplace mental health support. The question is whether employees have access to additional care if they need more than short-term support. As therapy costs rise and awareness continues to grow, reviewing mental health coverage can help ensure employees have access to the care they need, when they need it.

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At Prime Benefits Group, we can help you review your group benefits plans and identify practical options that fit your workforce and budget. Contact our team today if you’d like to explore how mental health coverage fits into your plan.